Bursitis pathophysiology

Jump to navigation Jump to search

Bursitis Microchapters

Home

Patient Information

Overview

Historical perspective

Classification

Pathophysiology

Causes

Differentiating Bursitis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Bursitis pathophysiology On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Bursitis pathophysiology

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Bursitis pathophysiology

CDC on Bursitis pathophysiology

Bursitis pathophysiology in the news

Blogs on Bursitis pathophysiology

Directions to Hospitals Treating Bursitis

Risk calculators and risk factors for Bursitis pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]

Overview

Bursitis is characterized by acute or chronic inflammation of a bursa and buildup of fluid in the bursal sac. A bursa is a small, fluid-filled sac that acts as a cushion between a bone and other moving parts: muscles, tendons, or skin. Over 160 bursae are found throughout the body, though relatively few of them can cause bursitis. Aseptic bursitis can be caused by overuse and repetitive injuries to the joint, abnormal bony structure, and crystal deposit in the bursa. It commonly affects the knee or the elbow as a result of kneeling or leaning on the elbows for a longer period of time than usual. Moreover, septic bursitis can be caused by bacterial infection of the bursa through skin injury following repetitive trauma.[1][2][3]

Pathophysiology

Bursitis is characterized by acute or chronic inflammation of a bursa and buildup of fluid in the bursal sac. A bursa is a small, fluid-filled sac that acts as a cushion between a bone and other moving parts: muscles, tendons, or skin. Over 160 bursae are found throughout the body, though relatively few of them can cause bursitis.

Aseptic

  • Bursitis commonly affects a knee or elbow, from kneeling or leaning on the elbows longer than usual on a hard surface.
  • Aseptic bursitis can be caused by the following factors:[3]
    • Injuries, overuse, and repetitive stress to the joint
    • Abnormal bony structures or soft-tissue changes that affect the movement of the joint
    • Crystal deposit in the bursa in patients with gout and pseudogout

Septic

  • Septic bursitis can be caused by bacterial infection of the bursa via the following routes:[1][2][3]
    • Through a skin injury following repetitive trauma
    • Via fistula (vascular access) in chronic hemodialysis patients
  • Bursa close to the surface of the skin are the most likely to become infected with bacteria. Common locations of septic bursitis include:
    • Olecranon bursitis (in carpenters, athletes, or hemodialysis patients)
    • Prepatellar or infrapatellar septic bursitis (in athletes and those whose occupations involve regular kneeling)
    • Ischiogluteal bursitis (in weavers and patients with spinal cord injuries)
    • A bursa on medial aspect of the first metatarsophalangeal joint (due to skin breakdown in patients with hallux valgus and inappropriate shoes)

Gross Pathology

On gross pathology, characteristic findings of bursitis include a thickened, erythematous, and shaggy bursal wall with fibrinous exudates.[4]

Thickened wall of the bursa result of chronic tuberculous infection - By Yale Rosen from USA - Tuberculous bursitisUploaded by CFCF, CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=31127387

Microscopic histopathological analysis

On microscopic histopathological analysis, chronic inflammation and scarring are characteristic findings of bursitis.

References

  1. 1.0 1.1 Fauci, Anthony S., and Carol Langford. Harrison's rheumatology. McGraw Hill Professional, 2010.
  2. 2.0 2.1 Hellmann DB, Imboden JB., Jr. Musculoskeletal and immunologic disorders. In: McPhee SJ, Papadakis MA, editors. Current Medical Diagnosis & Treatment. McGraw-Hill Lange; 2010. pp. 2056–2061.
  3. 3.0 3.1 3.2 García-Porrúa C, González-Gay MA, Ibañez D, García-País MJ (1999). "The clinical spectrum of severe septic bursitis in northwestern Spain: a 10 year study". J Rheumatol. 26 (3): 663–7. PMID 10090179.
  4. Wikimedia Commons. Bursitis. (2012) https://commons.wikimedia.org/wiki/Category:Bursitis Accessed on August 31, 2016

Template:WS Template:WH