The following common symptomatology is seen among patients with acute, chronic and recurrent bursitis:

• Joint pain and limitation of range of motion
• Joint stiffness
• Tenderness during palpation and movement
• Swelling of bursae and joint region
• Erythema over the joint area
• Unexplained bruising of the area of the bursae
• Reddish rash around the affected joint

Most of this signs and symptoms are conservatively treated at home or in a primary health facility. Patients are however advised to seek professional help if they experience the following with bursitis:

• Occurrence of fever
• Disabling joint pains
• Persistent joint pains for more than 1 to 2 weeks
• Excessive swelling and bruising in the affected area
• Sharp pain during exercise and exertion

The following diagnostic procedures and tests are commonly used among patients suffering from bursitis:

Imaging

Although X-ray radiographs cannot detect bursitis, this tool is most useful in ruling out any osseous pathology in the area that could mimic the symptom. Magnetic resonance imaging (MRI) and ultrasonology may be used to ascertain the diagnosis of bursitis when physical examination remains uncertain [7].

Laboratory tests

A fine needle may be inserted at the swollen bursae to harvest the inflamed fluids for laboratory testing. Tests may reveal the state of the inflammation and the type of organism that causes the infection within the bursae.

The majority of cases of bursitis are treated conservatively by affording adequate rest to affected area, application of ice packs, and the use of pain relievers. Where conservative management fails to offer palliative relief and resolution, the following therapies are being implored in cases of bursitis:

• Antibiotics when bursitis is found to be caused by an infective agent.
• Physical therapy to ease the pain and prevent the recurrence of the discomfort.
• Corticosteroid injections may be given directly to the bursae to afford instant relief of the pain among patients [8]. Corticosteroid injections can be guided accurately by the use of ultrasound [9].
• Assistive devices. The use of walkers and walking canes may assist the patient’s mobility and reduce pain symptoms during ambulation.
• Surgery. Inflamed and infected bursae may be surgically drained to relieve the pressure and shorten the clinical course of the disease. Sometimes the whole bursa is surgically removed to permanently address the recurrent problem [10].

There is a very low mortality rating for bursitis. Patients with bursitis are usually treated and followed up on an outpatient basis in most medical facilities. The prognosis of bursitis is generally good for all cases.

The most common cause of bursitis is associated with the repetitive movements and friction that may irritate the bursae. The following common movements and situations may give rise to bursitis:

• Repetitive pitching of a baseball
• Regular lifting of dumbbells overhead
• Extensive kneeling among monks and nuns
• Leaning on the elbows on an extended period of time
• Prolonged sitting on a hard surface 

The less common causes of bursitis include rheumatoid arthritis, gouty arthritis, and infectious arthritis [2].

The world prevalence rate of bursitis in primary care centers is only 4 out of 1000 patient visits. The most common sites of bursitis are the shoulder, elbow, hip, thigh and knee joints. Here is a high incidence of bursitis among athletes especially among the running sports, reaching an incidence ratio of up to 1 of 10 runners. Studies have revealed that men are more prone to bursitis especially those involved in heavy workload labor that involves frequent kneeling [3]. In septic superficial bursitis, men are more predisposed than women with a relative ratio of 17:3.

The advent of the repetitive trauma to the bursae over the joints encourages synovial cytosis. The thickening of the membranes through continuous collagen formation will increase fluid production within the joint. Chronically, this will result in granulation formation on the surface of the synovial which is followed by the onset of fibrosis. The fibrin rich fluid within the bursae can become hemorrhagic is some cases that could trigger an inflammation [4]. Studies relates that these reactions may be mediated by cyclooxygenases, metalloproteases, and cytokines during the inflammatory process.

By convention, there are three kinds of bursitis: Acute, recurrent and chronic forms [5]. Acute bursitis results during the sudden thickening of the synovial fluid causing pain during movement. Chronic bursitis results with long standing pain causing the weakening of the joint muscles, tendons, and ligaments as a complication. The recurrent forms are those sporadic and intermittent attacks of acute bursitis in a period of time like those seen in swimmers, gymnasts, and weight lifters [6].

There are some modifiable factors that can be resorted to prevent the recurrence of bursitis and allay its symptoms. The use of knee pads can greatly reduce the friction of the kneeling surface towards the afflicted bursa. Avoidance of lifting excessive weight loads will prevent the undue pressure on the hips and knee bursae. For those involved in repetitive tasks, frequent breaks may be needed to afford some rest on the bursae and joints involved. Changing one’s position frequently while doing repetitive tasks may also do the trick efficiently. Athletes should do pre-activity warm ups and stretching to strengthen the joints and the muscles around the bursae.

Bursitis is a clinical disease characterized by acute and chronic inflammation of the bursa. This inflammation is usually caused by repetitive trauma or friction, infections, and crystal depositions. Patients usually complain of pain during movement, tenderness, and swelling.

Bursitis is a disorder described as a painful swelling and inflammation of the fluid filled sacs that cushions the bone, muscles and tendons called bursae. These bursae are found in some of the major joints of the body including the shoulder, hip, elbow and the knee joints. Bursitis commonly occurs on joints that do frequent and repetitive movements. In bursitis, the synovial lining histologically thickens and produces excessive fluid that leads to localized swelling and tenderness [1]. Most of the cases are resolved within weeks after resting the affected site or by giving simple pain control measures.

Definition

Bursitis is a medical disorder described as a painful swelling and inflammation of the fluid filled sacs that cushion the bone, muscles and tendons called bursae.

Cause

 Bursitis is caused by any repetitive motion and friction over a bursa. It is caused by trauma, infections. It can also be secondry to crystal depositions.

Symptoms

The common symptoms the patient experiences is pain in the affected area, tenderness, limitation of movement, and swelling.

Diagnosis

The diagnosis of bursitis can be made by proper physical examination most of the times. Imaging studies sometimes can give a better clue. Specific diagnosis of the causative agent can sometimes be made by laboratory examination of bursa aspirate.

Treatment

Treatment involves adequate rest, applying ice packs, analgesics, antibiotics for infection, physical therapy, joint injections with corticosteroids, and surgery.

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