Bursitis history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]

Overview

The symptoms of bursitis vary based on the location of the inflammation. Focal swelling, pain, and redness are symptoms common to all forms of bursitis. Limbing, upper or lower extremity weakness, and fever are possible depending on the type of bursitis. Obtaining a complete history is helpful in determining whether the bursitis is associated with any specific hobbies or work-related activities.^[1]^[2]^[3]

History and symptoms

It is critical to collect a detailed and thorough history from the patient. Obtaining a complete history will be helpful in determining whether the bursitis is associated with any specific activities.

History

Specific areas to focus on when obtaining a history from the patient include:^[1]

History of repetitive movement
History of inflammatory disease (such as rheumatoid arthritis (RF), systemic lupus erythematosus (SLE))
History of trauma or microtrauma


Type of Bursitis	History
Subacromial bursitis^[2]	History of shoulder injury, tendinitis, or shoulder impingement syndrome History of muscle overuse or repetitive activity such as painting, throwing a ball, or playing tennis
Olecranon bursitis^[4]^[5]	History of direct trauma to the posterior elbow History of microtrauma, such as constantly rubbing the elbow against a table while writing History of certain occupations, such as plumbers and technicians History of systemic inflammatory processes such as rheumatoid arthritis History of crystal deposition disease, including gout and pseudogout
Trochanteric bursitis^[6]^[7]	History of trauma such as injury of the greater trochanter History of muscle overuse around the bursa or the joint underneath the bursa History of hip osteoarthritis History of inflammatory diseases Hip prosthesis
Prepatellar bursitis^[3]^[8]	History of sudden knee injury Hidtory of microtrauma History of staphylococcal infection History of inflammatory disease such as arthritis History of crystal arthropathy such as gout
Retrocalcaneal bursitis^[1]^[9]	History of tight-fitting shoes History of gout, rheumatoid arthritis, and seronegative spondyloarthropathies History of Haglund disease

Symptoms

The symptoms of bursitis differ based on the anatomic location. Localized pain with movement and decreased range of motion (ROM) are symptoms common to all forms of bursitis. Localized redness or warmth are variable and seen in superficial bursitis. Septic bursitis is associated with fever, in addition to other symptoms.


Type of Bursitis	Symptoms
Subacromial bursitis^[2]	Mid-shoulder pain early in the course of bursitis, which gradually increases over time; eventually pain may be felt even at rest Pain after repetitive activity such as painting, throwing a ball, or playing tennis Pain worsens at night Popping sensation with shoulder movements
Olecranon bursitis^[4]^[5]	Painful or painless focal swelling at the posterior elbow
Trochanteric bursitis^[6]^[7]	Pain in the lateral side of the hip with walking, running, or stair-climbing Weakness of the lower extremities Pain with active and passive motion
Prepatellar bursitis^[3]^[8]	Reduced range of motion at the knee Focal swelling, pain, and redness Difficulty kneeling and walking
Retrocalcaneal bursitis^[1]^[9]	Swelling at the back of heel Pain at the back of the heel, especially when running uphill Pain while standing on tiptoes

References

↑ ^1.0 ^1.1 ^1.2 ^1.3 Fauci, Anthony S., and Carol Langford. Harrison’s rheumatology. McGraw Hill Professional, 2010.
↑ ^2.0 ^2.1 ^2.2 Walker‐Bone, Karen, et al. “Prevalence and impact of musculoskeletal disorders of the upper limb in the general population.
↑ ^3.0 ^3.1 ^3.2 Aaron, Daniel L., et al. “Four common types of bursitis: diagnosis and management.” Journal of the American Academy of Orthopaedic Surgeons 19.6 (2011): 359-367.
↑ ^4.0 ^4.1 Stell IM (1996). “Septic and non-septic olecranon bursitis in the accident and emergency department–an approach to management”. J Accid Emerg Med. 13 (5): 351–3. PMC 1342774. PMID 8894865.
↑ ^5.0 ^5.1 Lockman L (2010). “Treating nonseptic olecranon bursitis: a 3-step technique”. Can Fam Physician. 56 (11): 1157. PMC 2980436. PMID 21075998.
↑ ^6.0 ^6.1 Brinks A, van Rijn RM, Bohnen AM, Slee GL, Verhaar JA, Koes BW; et al. (2007). “Effect of corticosteroid injection for trochanter pain syndrome: design of a randomised clinical trial in general practice”. BMC Musculoskelet Disord. 8: 95. doi:10.1186/1471-2474-8-95. PMC 2045096. PMID 17880718.
↑ ^7.0 ^7.1 Karpinski MR, Piggott H (1985). “Greater trochanteric pain syndrome. A report of 15 cases”. J Bone Joint Surg Br. 67 (5): 762–3. PMID 4055877.
↑ ^8.0 ^8.1 Huang, Yu-Chih, and Wen-Lin Yeh. “Endoscopic treatment of prepatellar bursitis.” International orthopaedics 35.3 (2011): 355-358.
↑ ^9.0 ^9.1 Lyman, Jeffrey, Paul S. Weinhold, and Louis C. Almekinders. “Strain behavior of the distal Achilles tendon implications for insertional Achilles tendinopathy.” The American Journal of Sports Medicine 32.2 (2004): 457-461.

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[Harrison-rheumatology-1] 1.0 ^1.1 ^1.2 ^1.3 Fauci, Anthony S., and Carol Langford. Harrison’s rheumatology. McGraw Hill Professional, 2010.

[bursitis-upper-limb-2] 2.0 ^2.1 ^2.2 Walker‐Bone, Karen, et al. “Prevalence and impact of musculoskeletal disorders of the upper limb in the general population.

[Bursitis-four-types-3] 3.0 ^3.1 ^3.2 Aaron, Daniel L., et al. “Four common types of bursitis: diagnosis and management.” Journal of the American Academy of Orthopaedic Surgeons 19.6 (2011): 359-367.

[pmid8894865-4] 4.0 ^4.1 Stell IM (1996). “Septic and non-septic olecranon bursitis in the accident and emergency department–an approach to management”. J Accid Emerg Med. 13 (5): 351–3. PMC 1342774. PMID 8894865.

[pmid21075998-5] 5.0 ^5.1 Lockman L (2010). “Treating nonseptic olecranon bursitis: a 3-step technique”. Can Fam Physician. 56 (11): 1157. PMC 2980436. PMID 21075998.

[pmid17880718-6] 6.0 ^6.1 Brinks A, van Rijn RM, Bohnen AM, Slee GL, Verhaar JA, Koes BW; et al. (2007). “Effect of corticosteroid injection for trochanter pain syndrome: design of a randomised clinical trial in general practice”. BMC Musculoskelet Disord. 8: 95. doi:10.1186/1471-2474-8-95. PMC 2045096. PMID 17880718.

[pmid4055877-7] 7.0 ^7.1 Karpinski MR, Piggott H (1985). “Greater trochanteric pain syndrome. A report of 15 cases”. J Bone Joint Surg Br. 67 (5): 762–3. PMID 4055877.

[Prepatellar-Bursitis-8] 8.0 ^8.1 Huang, Yu-Chih, and Wen-Lin Yeh. “Endoscopic treatment of prepatellar bursitis.” International orthopaedics 35.3 (2011): 355-358.

[Achilles-tendon-9] 9.0 ^9.1 Lyman, Jeffrey, Paul S. Weinhold, and Louis C. Almekinders. “Strain behavior of the distal Achilles tendon implications for insertional Achilles tendinopathy.” The American Journal of Sports Medicine 32.2 (2004): 457-461.

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