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
- 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)
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
Diagnostic tests
1st tests to order
- clinical diagnosis
Tests to consider
- Gram stain and culture of fluid aspirate
- crystal analysis
- x-ray of affected region
- MRI
- ultrasound
Treatment algorithm
non-septic bursitis
septic bursitis
Contributors
Authors
Nicola Maffulli, MD, MS, PhD, FRCS(Orth)

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

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

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
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
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მეტი დიფერენციული დიაგნოზებიშედით სისტემაში ან გამოიწერეთ BMJ Best Practice
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