Bursitis

{{short description|Inflammation of the bursae (sacs of synovial fluid in joints)}} {{Infobox medical condition | name = Bursitis | synonyms = student’s / plumber’s / miner’s elbow (olecranon bursitis), housemaid’s / carpenter’s / carpet layer’s knee (prepatellar bursitis), weaver’s / tailor’s bottom (ischial bursitis) | image = Bursitis Elbow WCArrow.jpg | caption = Example of olecranon bursitis | field = Orthopedics | symptoms = localized swelling, erythema, pain, decreased range of motion | causes = repetitive movements, excessive pressure, trauma, inflammatory conditions, autoimmune conditions, idiopathic | treatment = rest, ice, compression, elevation, anti-inflammatory and/or pain medication | types = acute and chronic; non-infected (aseptic) and infected (septic); subacromial (shoulders), olecranon (elbows), prepatellar (knees), trochanteric (hips), ischial (butt) }} '''Bursitis''' is the inflammation of one or more bursae in the body.<ref name=":0" /><ref name=":2" /><ref name=":1" /> Bursae are small sacs filled with lubricating synovial fluid that decrease friction at contact points between bones, skin, tendons, and muscle.<ref name=":0" /> Irritation of the bursae usually occurs as a result of overuse or trauma, but may also occur due to systemic illnesses.<ref name=":0" /><ref name=":2" /> While there are more than 150 bursae in the human body, common sites of bursitis include the shoulder, elbow, hip, and knee.<ref name=":1" /> Bursitis is typically associated with redness and swelling, but may also be associated with pain, warmth, or decreased range of motion.<ref name=":0" /><ref name=":2" /><ref name=":1" /> Bursitis is typically treated with conservative management (e.g. rest, ice, compression, elevation, anti-inflammatory and/or pain medication), but additional evaluation and treatment (e.g. steroid injections or surgery) may be required if initial management fails.<ref name=":0">{{Cite book |title=Conn's current therapy 2025: Rick D. Kellermann, David P. Rakel, Joel J. Heidelbaugh, Ernestine M. Lee |date=2025 |publisher=Elsevier |isbn=978-0-443-12181-4 |editor-last=Kellermann |editor-first=Rick D. |location=Philadelphia |editor-last2=Rakel |editor-first2=David |editor-last3=Heidelbaugh |editor-first3=Joel J. |editor-last4=Lee |editor-first4=Ernestine M.}}</ref><ref name=":1">{{Cite web |title=Bursitis - Symptoms and causes |url=https://www.mayoclinic.org/diseases-conditions/bursitis/symptoms-causes/syc-20353242 |access-date=2026-01-16 |website=Mayo Clinic |language=en}}</ref>

==Signs and symptoms== Bursitis presents with redness and swelling over the affected region.<ref name=":0" /><ref name=":1" /> It can be painful or painless.<ref name=":2" /> The presence of warmth may indicate an infectious bursitis (also known as septic bursitis).<ref name=":2" /> It can also be associated with pain with movement or decreased range of motion.<ref name=":1" /><ref name=":2" />

==Cause== The most common causes of bursitis are repetitive movements (e.g. throwing a ball, lifting an object) or positions (e.g. leaning on elbows, kneeling) that cause excessive pressure on the bursae.<ref name=":1" /><ref name=":2" /><ref name=":0" /> Direct trauma may also result in bursitis, with an increased risk of septic bursitis due to the introduction of bacteria if the overlying skin was damaged.<ref name=":2" /><ref name=":0" />

Less common causes include systemic inflammatory or autoimmune conditions such as arthritis (e.g. osteoarthritis, rheumatoid arthritis), gout, or lupus.<ref name=":1" /><ref name=":2" /><ref name=":0" />

Bursitis may also be idiopathic, with the exact cause unknown.<ref name=":2" />

== Mechanism == thumb|300x300px|3D image showing normal bursa (''left'') and bursitis (''right'') Bursitis is the inflammation of one or more bursae in the body.<ref name=":0" /><ref name=":1" /><ref name=":2" /> Bursae are sacs filled with a small amount of synovial fluid.<ref name=":0" /><ref name=":1" /><ref name=":2" /> Triggers such as overuse or trauma result in irritation that cause an increase in synovial fluid and enlargement of the bursae.<ref name=":0" /><ref name=":1" /><ref name=":2" /> Once enlarged, the inflamed bursae push on surrounding tissue (e.g bone, muscle, ligaments, skin) and cause symptoms (e.g. redness, swelling, pain, or decreased range of motion).<ref name=":0" /><ref name=":1" /><ref name=":2" />

==Diagnosis== The primary evaluation of suspected bursitis should include a thorough history and physical exam as bursitis is a clinical diagnosis.<ref name=":0" /><ref name=":1" /><ref name=":2">{{Citation |last=Williams |first=Christopher H. |title=Bursitis |date=2025 |work=StatPearls |url=http://www.ncbi.nlm.nih.gov/books/NBK513340/ |access-date=2026-01-22 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=30020712 |last2=Jamal |first2=Zohaib |last3=Sternard |first3=Britni T.}}</ref>

History taking helps identify the cause while also differentiating whether the bursitis is likely acute or chronic.<ref name=":2" /> While acute bursitis is typically painful, chronic bursitis can be painful or painless.<ref name=":2" />

Physical examination involves (1) visualization of the area for signs of erythema, swelling, or physical trauma, (2) palpation over the bursa to assess for warmth or tenderness, and (3) movement of the associated extremity to evaluate for pain or decreased range of motion.<ref>{{Cite book |title=Systematic musculoskeletal examinations |date=2012 |publisher=McGraw-Hill Education LLC |isbn=978-0-07-174521-5 |editor-last=Lawry |editor-first=George V. |edition=1st |series=McGraw-Hill's AccessMedicine |location=New York, N.Y}}</ref>

If septic or crystalline bursitis is suspected, removal of fluid via aspiration may be required to evaluate for signs of infection or crystals.<ref name=":0" /><ref name=":2" />

While imaging it is not required to diagnosis bursitis, it may still have utility for identifying the underlying cause (e.g. radiograph to reveal bony abnormalities) or support a suspected diagnosis (e.g. ultrasound or MRI to show fluid collections or soft tissue swelling).<ref name=":0" /><ref name=":1" />

==Treatment== Initial treatment of bursitis typically involves conservative management including rest, ice, compression, anti-inflammatory medications, and pain medications.<ref name=":0" /><ref name=":2" /><ref name=":1" /> Physical therapy may also help address associated issues (e.g. tendinopathies) to prevent recurrence.<ref name=":0" /><ref name=":2" /><ref name=":1" />

If conservative management fails, additional interventions, such as steroid injections or fluid removal via needle aspiration, may provide temporary relief.<ref name=":0" /><ref name=":2" /><ref name=":1" /> Rarely, removal of the bursa via bursectomy may be required.<ref name=":2" /><ref name=":1" />

In cases of suspected septic bursitis, treatment may require antibiotic therapy and fluid removal via incision and drainage.<ref name=":0" /><ref name=":2" />

Treatment of the less common causes of bursitis (e.g. systemic inflammatory or autoimmune conditions) should involve treatment of the underlying cause.<ref name=":2" />

== Prevention == Prevention of bursitis primarily involves avoidance of triggers (e.g. excessive pressure or repetitive movements) and activity modification (e.g. using elbow or knee pads, proper lift techniques, frequent breaks).<ref name=":2" /><ref name=":1" />

If an underlying cause (e.g. systemic inflammatory or autoimmune condition such as arthritis, gout, or lupus) is identified, it should be treated.<ref name=":2" />

==References== {{Reflist}}

== External links == {{Commons category|Bursitis}} * Bursitis – [https://www.mayoclinic.org/diseases-conditions/bursitis/symptoms-causes/syc-20353242 Symptoms and Causes] / [https://www.mayoclinic.org/diseases-conditions/bursitis/diagnosis-treatment/drc-20353247 Diagnosis and Treatment] from Mayo Clinic * [https://my.clevelandclinic.org/health/diseases/10918-bursitis Bursitis: Types, Treatment & Prevention] from Cleveland Clinic

{{Medical resources | DiseasesDB = 31623 | ICD10 = {{ICD10|M|70||m|70}}–{{ICD10|M|71||m|70}} | ICD9 = {{ICD9|727.3}} | ICDO = | OMIM = | MedlinePlus = 000419 | eMedicineSubj = emerg | eMedicineTopic = 74 | MeshID = D002062 }} {{Soft tissue disorders}}

Category:Inflammations Category:Soft tissue disorders Category:Synovial bursae