Bursitis physical examination

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

Overview

Physical examination of patients with bursitis is usually remarkable for redness, swelling, reduced range of motion, and warmth over the involved joint. However, physical examination findings may vary based on the particular bursitis subtype.

Physical examination

Physical examination of patients with bursitis is usually remarkable for redness, swelling, reduced range of motion, and warmth over the involved joint. However, physical examination findings may vary based on the particular bursitis subtype.


Type of Bursitis	Physical examination	Maneuver
Subacromial bursitis^[1]	Redness, swelling, and warmth over the shoulder Shoulder stiffness Lateral or anterior shoulder tenderness on palpation Reduced active range of motion (ROM) with decreased elevation, internal rotation and abduction	Speed’s test (not specific) Neer’s test (not specific) Empty beer can test (help to differentiate from supraspinatus tendinitis) Impingement test (also positive in rotator cuff injury) Glenohumeral abduction
Olecranon bursitis^[2]^[3]	Abrasion or contusion of skin (in a case of trauma) Swelling, at the posterior elbow Goose egg appearance over the olecranon process Tenderness for palpation at the affected site Systemic inflammatory processes Fever Rheumatoid nodules
Trochanteric bursitis^[4]^[5]	Tenderness at lateral hip, aggravated by active and passive external rotation and abduction Lateral hip pain on direct palpation Weakness of the hip-abductors	Ober’s Test (reduced range of motion was significant) Resistance test (pain and tenderness with resisting at external rotation)
Prepatellar bursitis^[6]^[7]	Erythema at the affected site (knee) Ususally very large swelling over the knee Tenderness aggravated by bending and stretching the knee Reduced active range of motion (ROM)
Retrocalcaneal bursitis^[8]^[9]	Swelling at the back of heel Tenderness at the back of heel Painful ankle dorsiflexion

Prepatellar bursitis<ref> Wikipedia.Prepatellar bursitis. https://en.wikipedia.org/wiki/Prepatellar_bursitis#/media/File:Prepatellar_bursitis.JPG Accessed on August 25, 2016</red>
Prepatellar bursitis
Olecranon bursitis<ref> Wikipedia.Prepatellar bursitis. https://en.wikipedia.org/wiki/Bursitis#/media/File:Bursitis_Elbow_WC.JPG Accessed on August 25, 2016</red>
Olecranon bursitis

References

↑ Walker‐Bone, Karen, et al. “Prevalence and impact of musculoskeletal disorders of the upper limb in the general population.
↑ 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.
↑ Lockman L (2010). “Treating nonseptic olecranon bursitis: a 3-step technique”. Can Fam Physician. 56 (11): 1157. PMC 2980436. PMID 21075998.
↑ 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.
↑ 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.
↑ 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.
↑ Huang, Yu-Chih, and Wen-Lin Yeh. “Endoscopic treatment of prepatellar bursitis.” International orthopaedics 35.3 (2011): 355-358.
↑ Fauci, Anthony S., and Carol Langford. Harrison’s rheumatology. McGraw Hill Professional, 2010.
↑ 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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[bursitis-upper-limb-1] Walker‐Bone, Karen, et al. “Prevalence and impact of musculoskeletal disorders of the upper limb in the general population.

[pmid8894865-2] 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.

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

[pmid17880718-4] 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.

[pmid4055877-5] 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.

[Bursitis-four-types-6] 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.

[Prepatellar-Bursitis-7] Huang, Yu-Chih, and Wen-Lin Yeh. “Endoscopic treatment of prepatellar bursitis.” International orthopaedics 35.3 (2011): 355-358.

[Harrison-rheumatology-8] Fauci, Anthony S., and Carol Langford. Harrison’s rheumatology. McGraw Hill Professional, 2010.

[Achilles-tendon-9] 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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Bursitis physical examination

Overview

Physical examination

References

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