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Bursitis

Last reviewed: 3 Aug 2025
Last updated: 10 May 2024

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
Full details

Other diagnostic factors

  • presence of risk factors
  • 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)
Full details

Risk factors

  • 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
  • anatomical or functional impingement within the coracoacromial arch
Full details

Diagnostic tests

1st tests to order

  • clinical diagnosis
Full details

Tests to consider

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

Treatment algorithm

ACUTE

non-septic bursitis

septic bursitis

Contributors

Authors

Nicola Maffulli, MD, MS, PhD, FRCS(Orth)
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 an author of a number of references cited in this topic.

Umile Giuseppe Longo, MD, MSc, PhD
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 topic.

Vincenzo Denaro, MD
Vincenzo Denaro

Professor and Head of Orthopaedic and Trauma Surgery

Dean of the Faculty of Medicine

Campus Bio-Medico University

Trigoria

Rome

Italy

გაფრთხილება:

VD declares that he has no competing interests.

რეცენზენტები

Steven C. Vlad, MD, PhD

Assistant Professor and Attending Physician of Rheumatology

Division of Rheumatology

Tufts Medical Center

Boston

MA

გაფრთხილება:

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

გაფრთხილება:

FO declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

წყაროები

ჩვენი მტკიცებულებებისა და სარედაქციო ჯგუფები თანამშრომლობენ საერთაშორისო ექსპერტებსა და რეცენზენტებთან, რათა უზრუნველვყოთ თქვენი წვდომა კლინიკურად ყველაზე მნიშვნელოვან ინფორმაციაზე.

ძირითადი სტატიები

Alvarez-Nemegyei J, Canoso JJ. Evidence-based soft tissue rheumatology: III: trochanteric bursitis. J Clin Rheumatol. 2004 Jun;10(3):123-4. აბსტრაქტი

Alvarez-Nemegyei J, Canoso JJ. Evidence-based soft tissue rheumatology IV: anserine bursitis. J Clin Rheumatol. 2004 Aug;10(4):205-6. აბსტრაქტი

Expert Panel on Musculoskeletal Imaging; Jawetz ST, Fox MG, Blankenbaker DG, et al. ACR appropriateness criteria® chronic hip pain: 2022 update. J Am Coll Radiol. 2023 May;20(5s):S33-48. აბსტრაქტი

Expert Panel on Musculoskeletal Imaging; Fox MG, Chang EY, Amini B, et al. ACR appropriateness criteria(®) chronic knee pain. J Am Coll Radiol. 2018 Nov;15(11s):S302-12.სრული ტექსტი  აბსტრაქტი

Expert Panel on Musculoskeletal Imaging; Nicholas N, Fox MG, Blankenbaker DG, et al. ACR appropriateness criteria® chronic shoulder pain: 2022 update. J Am Coll Radiol. 2023 May;20(5s):S49-69. აბსტრაქტი

გამოყენებული სტატიები

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