| History: Individuals with bursitis may report localized tenderness, warmth, swelling (edema), redness (erythema) of the skin, a dull ache or stiffness, worsening of pain with movement or pressure, and limited joint movement. If the bursa is infected, the individual may report systemic symptoms including fever and red streaks leading from the affected area. Questions should be directed to a history of recent trauma directly over the bursae or to repetitive activity. Physical exam: Visual inspection may reveal edema and erythema. Skin should be inspected for breakdown and possible entry of a foreign object. Touching (palpation) the affected joint and bursae often reveals soft, boggy, or tense tissue depending on the amount of fluid build up. The bursa will be tender. Motion is limited by pain and edema in acute cases. Chronic cases may show decreased range of motion from adhesions and thickening of the tissue. Muscle weakness may develop from lack of use (disuse atrophy). Tests: Plain x-rays of the joint and surrounding area generally are not helpful in confirming the diagnosis but may be used to rule out other conditions and to detect the calcium deposits often seen in chronic bursitis. It is important to look for changes in the bone from chronic irritation and to rule out bone infection (osteomyelitis). MRI and ultrasound may be used to help confirm bursitis in bursae located deeper within the body, such as those in the hip. A portion of the bursa fluid may be withdrawn using a needle (aspirated) and examined to rule out gout and infection (synovial fluid analysis). If infection is suspected, erythrocyte sedimentation rate (ESR) and complete blood count (CBC) tests may be ordered. If infection is suspected in the adjacent joint, fluid may be withdrawn for evaluation (arthrocentesis). |
Source: Medical Disability Advisor