Highlights & Basics
- Bursitis is acute or chronic inflammation of a bursa.
- In bursitis there is thickening and proliferation of the synovial lining, bursal adhesions, villus formation, tags, and deposition of chalky deposits. This may result from repetitive stress, infection, autoimmune disease, or trauma.
- Key diagnostic findings are localized pain and tenderness over a bursa and swelling if superficially sited.
- Treatment for nonseptic bursitis involves modified physical activity, rest, and analgesia. Corticosteroid injections are reserved for those cases that do not respond to conservative management. Bursal excision is a last resort.
- The first-line treatment for septic bursitis is aspiration and antibiotic therapy. Surgical debridement and lavage may be required.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
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Citations
Alvarez-Nemegyei J, Canoso JJ. Evidence-based soft tissue rheumatology: III: trochanteric bursitis. J Clin Rheumatol. 2004 Jun;10(3):123-4.[Abstract]
Alvarez-Nemegyei J, Canoso JJ. Evidence-based soft tissue rheumatology IV: anserine bursitis. J Clin Rheumatol. 2004 Aug;10(4):205-6.[Abstract]
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.[Abstract]
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.[Abstract][Full Text]
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.[Abstract]
1. Kozlov DB, Sonin AH. Iliopsoas bursitis: diagnosis by MRI. J Comput Assist Tomogr. 1998 Jul-Aug;22(4):625-628.[Abstract]
2. Lievense A, Bierma-Zeinstra S, Schouten B, et al. Prognosis of trochanteric pain in primary care. Br J Gen Pract. 2005 Mar;55(512):199-204.[Abstract][Full Text]
3. Baumbach SF, Lobo CM, Badyine I, et al. Prepatellar and olecranon bursitis: literature review and development of a treatment algorithm. Arch Orthop Trauma Surg. 2014 Mar;134(3):359-70.[Abstract]
4. Alvarez-Nemegyei J. Risk factors for pes anserinus tendinitis/bursitis syndrome: a case control study. J Clin Rheumatol. 2007 Apr;13(2):63-5.[Abstract]
5. Alvarez-Nemegyei J, Canoso JJ. Evidence-based soft tissue rheumatology: III: trochanteric bursitis. J Clin Rheumatol. 2004 Jun;10(3):123-4.[Abstract]
6. Alvarez-Nemegyei J, Canoso JJ. Evidence-based soft tissue rheumatology IV: anserine bursitis. J Clin Rheumatol. 2004 Aug;10(4):205-6.[Abstract]
7. Silva F, Adams T, Feinstein J, et al. Trochanteric bursitis: refuting the myth of inflammation. J Clin Rheumatol. 2008 Apr;14(2):82-86.[Abstract]
8. Alvarez-Nemegyei J, Canoso JJ. Heel pain: diagnosis and treatment, step by step. Cleve Clin J Med. 2006 May;73(5):465-71.[Abstract]
9. Mazzone MF, McCue T. Common conditions of the Achilles tendon. Am Fam Physician. 2002 May 1;65(9):1805-11.[Abstract][Full Text]
10. Alvarez-Nemegyei J, Canoso JJ. Evidence-based soft tissue rheumatology. Part I: subacromial impingement syndrome. J Clin Rheumatol. 2003 Jun;9(3):193-9.[Abstract]
11. Longo UG, Franceschi F, Ruzzini L, et al. Histopathology of the supraspinatus tendon in rotator cuff tears. Am J Sports Med. 2008 Mar;36(3):533-38.[Abstract]
12. Ege Rasmussen KJ, Fano N. Trochanteric bursitis: treatment by corticosteroid injection. Scand J Rheumatol. 1985;14(4):417-20.[Abstract]
13. Rompe JD, Furia J, Maffulli N. Eccentric loading compared with shock wave treatment for chronic insertional Achilles tendinopathy: a randomized, controlled trial. J Bone Joint Surg Am. 2008 Jan;90(1):52-61.[Abstract]
14. 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.[Abstract]
15. 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.[Abstract][Full Text]
16. 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.[Abstract]
17. Small LN, Ross JJ. Suppurative tenosynovitis and septic bursitis. Infect Dis Clin North Am. 2005 Dec;19(4):991-1005.[Abstract]
18. Tennent TD, Beach WR, Meyers JF. A review of the special tests associated with shoulder examination. Part II: laxity, instability, and superior labral anterior and posterior (SLAP) lesions. Am J Sports Med. 2003 Mar-Apr;31(2):301-7.[Abstract]
19. Kim JY, Chung SW, Kim JH, et al. A randomized trial among compression plus nonsteroidal antiinflammatory drugs, aspiration, and aspiration with steroid injection for nonseptic olecranon bursitis. Clin Orthop Relat Res. 2016 Mar;474(3):776-83.[Abstract][Full Text]
20. Koester MC, Dunn WR, Kuhn JE, et al. The efficacy of subacromial corticosteroid injection in the treatment of rotator cuff disease: a systematic review. J Am Acad Orthop Surg. 2007 Jan;15(1):3-11.[Abstract]
21. Buchbinder R, Green S, Youd JM. Corticosteroid injections for shoulder pain. Cochrane Database Syst Rev. 2003;(1):CD004016.[Abstract][Full Text]
22. Smith DL, McAfee JH, Lucas LM, et al. Treatment of nonseptic olecranon bursitis. A controlled, blinded prospective trial. Arch Intern Med. 1989 Nov;149(11):2527-30.[Abstract]
23. Shbeeb MI, O'Duffy JD, Michet CJ Jr, et al. Evaluation of glucocorticosteroid injection for the treatment of trochanteric bursitis. J Rheumatol. 1996 Dec;23(12):2104-6.[Abstract]
24. Kelly BT, Williams RJ 3rd, Philippon MJ. Hip arthroscopy: current indications, treatment options, and management issues. Am J Sports Med. 2003 Nov-Dec;31(6):1020-37.[Abstract]
25. Lustenberger DP, Ng VY, Best TM, et al. Efficacy of treatment of trochanteric bursitis: a systematic review. Clin J Sport Med. 2011 Sep;21(5):447-53.[Abstract]
26. Krishna Sayana M, Maffulli N. Insertional Achilles tendinopathy. Foot Ankle Clin. 2005 Jun;10(2):309-320.[Abstract]
27. Wiegerinck JI, Kok AC, van Dijk CN. Surgical treatment of chronic retrocalcaneal bursitis. Arthroscopy. 2012 Feb;28(2):283-93.[Abstract]
28. Harper KD, Park KJ, Incavo SJ. Management of hip abductor tears and recalcitrant trochanteric bursitis in native hips. J Am Acad Orthop Surg. 2023 Oct 1;31(19):e769-77.[Abstract]
29. McAfee JH, Smith DL. Olecranon and prepatellar bursitis: diagnosis and treatment. West J Med. 1988 Nov;149(5):607-10.[Abstract][Full Text]
30. Rompe JD, Furia J, Weil L, et al. Shock wave therapy for chronic plantar fasciopathy. Br Med Bull. 2007;81-82:183-208. [Abstract][Full Text]
31. Notarnicola A, Ladisa I, Lanzilotta P, et al. Shock waves and therapeutic exercise in greater trochanteric pain syndrome: a prospective randomized clinical trial with cross-over. J Pers Med. 2023 Jun 10;13(6):976.[Abstract][Full Text]
