Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • pain at site of bursa
  • tenderness to palpation at site of bursa
  • decreased active range of motion

Other diagnostic factors

  • presence of risk factors
  • low-grade temperature (septic bursitis)
  • swelling
  • erythema (septic bursitis)
  • warmth of overlying skin (septic bursitis)
  • painful arc on shoulder abduction (subacromial)
  • lateral hip pain (trochanteric)
  • pain at the extremes of hip rotation, abduction, or adduction (trochanteric)
  • pain of contraction of the hip abductors against resistance (trochanteric)
  • pseudoradiculopathy: pain radiating down the lateral aspect of the thigh (trochanteric)
  • impalpable patella (prepatellar)
  • palpable bump over heel (retrocalcaneal)

Risk factors

  • occupation that causes mechanical stress on bursa
  • rheumatoid arthritis
  • gout or pseudogout
  • penetrating injury
  • osteoarthritis of the hip
  • infection in a nearby joint
  • lower limb length discrepancy
  • iliotibial band contracture
  • lumbar spondylosis
  • valgus knee deformity
  • low-riding shoes
  • anatomical or functional impingement within the coracoacromial arch

Diagnostic investigations

Investigations to consider

  • Gram stain and culture of fluid aspirate
  • crystal analysis
  • x-ray of affected region
  • MRI
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Nicola Maffulli

Centre Lead and Professor of Sports and Exercise Medicine

Consultant Trauma and Orthopaedic Surgeon

Queen Mary University of London

Barts and The London School of Medicine and Dentistry

William Harvey Research Institute

Centre for Sports and Exercise Medicine

Mile End Hospital

London

UK

Disclosures

NM is Editor in Chief of Muscles, Ligaments and Tendons Journal and the Journal of Orthopaedic Surgery and Research. NM is an author of a number of references cited in this monograph.

Umile Giuseppe Longo

Specialist in Orthopaedic and Trauma Surgery

Department of Orthopaedic and Trauma Surgery

Campus Bio-Medico University

Trigoria

Rome

Italy

Disclosures

UGL is an author of a number of references cited in this monograph.

Vincenzo Denaro

Professor and Head of Orthopaedic and Trauma Surgery

Dean of the Faculty of Medicine

Campus Bio-Medico University

Trigoria

Rome

Italy

Disclosures

VD declares that he has no competing interests.

Peer reviewers VIEW ALL

Orthopedic Surgeon

University of Massachusetts Medical School

Leominster

MA

Disclosures

KB declares that he has no competing interests.

Specialist in Orthopedics and Trauma

Studi di Roma "Tor Vergata"

Grottaferrata

Rome

Italy

Disclosures

FO declares that he has no competing interests.

Use of this content is subject to our disclaimer