小结
定义
病史和体格检查
关键诊断因素
- pain at site of bursa
- tenderness to palpation at site of bursa
- decreased active range of motion
其他诊断因素
- low-grade temperature
- swelling
- erythema
- warmth of overlying skin
- 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)
危险因素
- occupation that causes mechanical stress on bursa
- rheumatoid arthritis
- gout or calcium pyrophosphate deposition disease
- 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
- anatomic or functional impingement within the coracoacromial arch
诊断性检查
首要检查
- clinical diagnosis
需考虑的检查
- Gram stain and culture of fluid aspirate
- crystal analysis
- x-ray of affected region
- MRI
- ultrasound
治疗流程
nonseptic bursitis
septic bursitis
撰稿人
作者
Nicola Maffulli, MD, MS, PhD, FRCS(Orth)
![Nicola Maffulli](/api/image/523/en-us/normal/523-auth-1_default.jpg)
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
利益声明
NM is an author of a number of references cited in this topic.
Umile Giuseppe Longo, MD, MSc, PhD
![Umile Giuseppe Longo](/api/image/523/en-us/normal/523-auth-2_default.jpg)
Specialist in Orthopaedic and Trauma Surgery
Department of Orthopaedic and Trauma Surgery
Campus Bio-Medico University
Trigoria
Rome
Italy
利益声明
UGL is an author of a number of references cited in this topic.
Vincenzo Denaro, MD
![Vincenzo Denaro](/api/image/523/en-us/normal/523-auth-3_default.jpg)
Professor and Head of Orthopaedic and Trauma Surgery
Dean of the Faculty of Medicine
Campus Bio-Medico University
Trigoria
Rome
Italy
利益声明
VD declares that he has no competing interests.
同行评议者
Steven C. Vlad, MD, PhD
Assistant Professor and Attending Physician of Rheumatology
Division of Rheumatology
Tufts Medical Center
Boston
MA
利益声明
SCV declares that he has no competing interests.
Franceso Oliva, MD, PhD
Specialist in Orthopedics and Trauma
Studi di Roma "Tor Vergata"
Grottaferrata
Rome
Italy
利益声明
FO declares that he has no competing interests.
鉴别诊断
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