Bursitis: what is it and how to treat it?

What is bursitis: from what arises and how to treat the disease

Why does such a disease arise as bursitis and how to cure it? This question is asked by many patients who had to face this disease. Bursitis is a purulent inflammation that affects the bursa (periarticular synovial bag).

The disease causes the formation and accumulation of synovial fluid, in one word exudate. A synovial bag or capsule is located between the bones and tendons, which are under strong pressure.

Most often, elbows, shoulder, knee and hip joints suffer from bursitis. Usually the disease lasts 1-2 weeks and does not pose a threat to the life of the patient. But secondary trauma can cause the development of chronic bursitis, whose treatment is very difficult.

In addition to the patient experiencing persistent pain, he is also limited in movement, as the mobility of the joint is impaired.

The risk group of bursitis includes athletes (skiers, golfers, tennis players), and people whose profession involves hard physical labor (builders, miners, loaders).

Causes of bursitis

Usually bursitis appears after stretching or other trauma, sometimes the cause of the disease can become an infection or intoxication, metabolic disorders, an allergic reaction, autoimmune processes. The disease can appear as a complication of the flu, but often its manifestations arise for no apparent reason.

An impetus to the development of inflammation of the periarticular capsule or bag can serve as a different kind of gneiss microbes. A repeated trauma for their development creates very favorable conditions. For this reason, some forms of bursitis are classified as occupational diseases.

From a purulent foci (carbuncle, furuncle, osteomyelitis) that appeared near the synovial bag lymphatic pathways or through small lesions of the skin, gneiss microbes penetrate into the synovial bag. Regular mechanical damage causes congestion of serous or purulent exudate.

Often, the damage to diarthrosis is the result of a large overload that has affected the joint for a long time.

Similar repeated physical strains can be swings at the game of golf.

The disease is ironically called "maid's knees as it often provokes a long standing on your knees during washing or cleaning. In addition, the cause of bursitis can be arthritis or gout.

Symptoms of the disease

Symptoms of this disease, especially:

• swelling;
• pain syndrome;
• inflammation in the joint area, which is especially noticeable in physical training (stretching or warm-up).
• redness of the skin in the area of ​​inflammation;
• increase in local temperature.

The amplitude of the patient's movements becomes sharply limited. Even minor physical activity, involving employment of the affected joint, causes excruciating pain.

Bursitis, depending on the course, is acute (occurs suddenly and progresses rapidly) and chronic (remains with the patient for a long time).

Symptoms of bursitis acute - this, of course, a strong pain, which becomes unbearable during movements. Pain always arises in the place of localization of the inflammatory process. For example, with shoulder bursitis, it is very difficult for the patient to take his hand behind his head at the time of combing or dressing.

Often the pain in the inflamed joint radiates to the neck or lower arm. Pain intensifies at night. Because of what the patient may not close his eyes.

Chronic bursitis is characterized by a lesser intensity of pain, but the duration is longer. The tissue that grows around the diseased joint, eventually binds the bones and deprives the joint of mobility.

How to treat bursitis

How to treat bursitis can only know a doctor. First of all, the treatment of bursitis depends on:

1. forms of pathology;
2. spread of infection;
3. changes in inflamed tissues;
4. symptoms.

If the patient is diagnosed with acute bursitis, treatment should be conservative. This state requires the immovability of the joint and complete rest. For this, immobilization (immobilization) of the joint by a special langette is effected.

Note! Symptoms of acute pain often go away on their own.

But if the pain becomes too painful, it can be reduced with aspirin.

If this drug does not bring the patient relief, more effective anti-inflammatory and analgesic agents can be used.

Sometimes an affected joint bag is injected with hydrocortisone or novocaine. To ensure the resorption of exudate dry heat, methods of physiotherapy, compresses using Vishnevsky ointment are used.

Treatment of bursitis caused by trauma is carried out in an operative way. This development of the disease often involves the removal of deposits of calcium salts, since growths can be large and cause discomfort during movement.

Calcium salts are removed by needle extraction or by surgery.

Treatment of non-infectious bursitis requires temporary immobilization of the joint. The patient must be in a slightly raised position. On affected diarrtosis, ice should be applied. For internal administration, large doses of indomethacin, naproxen, ibuprofen are prescribed.

If the bursitis occurs for a long time, the suction of the exudate with further administration, -2 ml of triamcinolone or 5-40 mg of methylprednisolone is produced from the synovial bag. But this is possible only in the event that the infectious cause of the disease is absolutely excluded.

To treat an acute bursitis of the elbow or knee joint necessarily follows in the complex. Here's what you need to do:

• immobilizing joints pressing bandages;
• ointments with anti-inflammatory effect;
• warming compresses;
• biological supplements with glucosamine.

To combat chronic bursitis appoint indomethacin, naproxen or ibuprofen. The complex of therapeutic measures must include gymnastics. In addition, treatment of elbow bursitis with folk remedies is permitted.

When calcifying chronic bursitis calcitans (the zones in which accumulation of calcium salts occur) are removed by the operative method. If relapses happen too often, the joint bag is removed.

Treatment with folk methods

Traditional medicine also does not stand aside when it comes to bursitis. The most popular way to fight the disease is compresses.

For example, a compress made from common salt, for the preparation of which a highly concentrated solution of salt and water is prepared. Ratio: 1 tbsp. a spoonful of salt for 500 ml of boiling water.

After such a compress, a pathological fluid accumulates under the skin, which then exits. To perform this procedure, you need to take a piece of flannel or woolen cloth and soak it with the prepared salt solution.

The tissue should be applied to the diseased part of the body and tightly wound with food film. Next, the limb should be wrapped.

Keep such a salt compress is recommended 5-8 hours and it should be noted that salt compresses on the joints are quite effective.

An excellent anti-inflammatory and analgesic effect has cabbage leaves, or rather, compresses of them. Prepare this application is very simple: you need to take a clean cabbage leaf, remove from it with a knife all the rough streaks and slightly repel with a wooden hammer until the juice appears.

An inflamed area is smeared with honey and a cabbage leaf is placed on it. Then wrap the food film and carefully insulate.

Well-proven in the treatment of bursitis coniferous and herbal baths, as well as ointment, which is prepared from 2 parts of liquid honey 1 part of the juice of an aloe leaf and 3 parts of ethyl alcohol.

For faster dissolving of exudate, removal of inflammation and elimination of discomfort in bursitis, physiotherapeutic methods of treatment are used:

• ultrasound - action by mechanical elastic oscillations of waves at high frequency;
• diathermy - treatment by high-frequency currents with the use of their thermal effect. This method relaxes spasmodic tendons, nerves and muscles;
• cryotherapy - cold treatment. This technique is considered innovative.

When purulent bursitis requires surgical intervention - the abscess of the articular bag is opened and pus is removed from it. After this, it is necessary to sanitize the wound, which consists in the removal of dead tissue. After such an operation, a long rehabilitation period follows

Prevention of bursitis

To prevent bursitis, one can not perform actions that cause discomfort in the joint or hurt him. Ligaments and muscles should always be in good shape. This is facilitated by daily exercise.

If damage is obtained in the area of ​​the synovial bag, it is necessary to carefully treat the wound using hydrogen peroxide and put a bactericidal bandage on the damaged area.

A source: http://sustav.info/bolezni/bursitis/bursit-lechenie.html

Bursitis - causes, symptoms and treatment of the disease

The human musculoskeletal system is a rather complex "mechanism" that is tested for life.

Periodically arising problems with joints cause a lot of trouble.

One of these unpleasant diseases is bursitis, which treatment should be started with the first symptoms.

Bursitis - inflammation of the synovial bag, accompanied by the accumulation of fluid (exudate). Synovial bags are located where there are muscles.

They play the role of shock absorber, reducing pressure and reducing the friction of tissues during movement. Most often inflamed synovial bags of the shoulder, elbow and knee joints.

These joints are most susceptible to injury, especially in athletes, which makes it possible to characterize bursitis as an occupational disease.

The duration of the inflammatory process is about two weeks. Repeated bursitis lasts much longer, turning into a chronic form.

Signs of bursitis

In the place of damage to the joint there is swelling due to fluid accumulation. This fluid - exudate, is formed due to the decomposition of accumulated blood.

Such a neoplasm is called exudative effusion. The tissues adjacent to the joint are squeezed, and transudate enters the space between the cells.

There is pain due to pressure on the nerve endings.

As the tumor develops, salts of calcium are deposited on the walls of the articular sac, causing imbalance. For the dissolution of calcification, magnesium preparations are used.

Causes of the disease

The main reason why a disease occurs is any trauma, bruising or stretching. When this is "mixed" with the infection - a purulent inflammation is inevitable.

For example, a furuncle, which appeared next to a synovial bag, is the source of microbes that penetrate into the synovial sac with blood flow. Serous or purulent exudate, it stretches it.

As a result, a tumor is formed. Other causes of the disease may include:

1. Inflammatory diseases of the joints: arthritis, gout, furunculosis, erysipelas, osteomyelitis.
2. Acute respiratory viral infections, influenza, bronchitis, abscess.
3. Violation of the metabolic process.
4. Flat feet, wearing uncomfortable shoes.
5. Mechanical injuries of the bursa.
6. Calcine of tendons.
7. Allergy, poisoning.
8. Autoimmune diseases.
9. Diseases of ENT organs: tonsillitis, sinusitis, otitis media.

Throughout life, joints experience excessive stresses and the consequences of this "will not keep you waiting."

Although the risk group is mainly athletes: golfers, cyclists, football players, etc., bursitis can appear in everyone.

Lovers of high heels also risk on a par with athletes, porters or people with excess weight.

Symptoms of the disease

The appearance of a swelling in the area of ​​the injury, accompanied by pain and a local increase in temperature is the main symptom of bursitis.

The movements of the damaged joint are hampered, the skin around the inflammation turns red, the pain syndrome increases.

Puffiness occurs at the location of the synovial bag and reaches a diameter of 10 cm. Common symptoms of bursitis:

• Exudate accumulation in the bursa;
• Strong pains that increase during sleep and give to the limb;

• Limited movement due to calcification of the walls of the bag;
• Edema of the intercellular space;
• Hyperemia (redness of the skin in the area of ​​inflammation);
• Increase in body temperature, first in the place of pain localization, and then general (up to 400);
• Nausea, dizziness, weakness;
• Enlargement of lymph nodes.

Kinds

By nature of pain distinguish between acute and chronic bursitis. Acute inflammation occurs instantaneously literally in 1-2 days.

Chronic course of the disease lasts for years, with periodic exacerbation and manifestation of symptoms.

And when the amount of accumulated fluid in the cavity of the edema reaches a critical level, a hygroma (cyst) is formed. Since the causes of bursitis are different, there are also different types:

1. Infectious (septic);
2. Traumatic (aseptic).

In bursitis, the infection penetrates either because of a breach of the integrity of the skin, or through the lymphatic pathways or blood.

Infectious agents are the following microorganisms: gonococci, staphylococci, streptococci, pneumococci. And also brucellosis, tuberculosis or E. coli.

Where does bursitis develop?

In the human body, there are about 150 synovial bags that help the joints work. The contact points of moving bones, ligaments, tendons soften the bursa. It provides movement of the shoulder, elbow, knee, ankle, and also the femoral joint.

It is these joints that are more susceptible to bursitis. Since the bags are located in different places, the disease develops either in the subcutaneous tissue (subcutaneous bursitis) or in the subfascial cell space.

Another axillary and subconscious bursitis.

A) Bursitis of the shoulder joint V) Knee-joint C) Hip D) Elbow

Treatment

Regardless of the localization of pain, the main components of the fight against the disease are the peace and immobility of the joint. How to treat bursitis depends on the type of inflammation, but in any case it will be a complex therapy. What is included in it:

1. Drug treatment.
2. Massage.
3. Physiotherapy.
4. Diet.

The drug treatment of bursitis is aimed at reducing pain and suppressing the inflammatory process. To do this, antibiotics, anesthetics, drugs to improve immunity are used. On the pain site, Vishnevsky's ointment is applied, which contributes to the resorption of the exudate.

In acute non-infectious bursitis, aspirin is used to relieve pain. If this does not help, do intramuscular injections of novocaine or hydrocortisone.

Of the tablets appoint: ibuprofen, naproxen, indomethacin. The dosage depends on how strong the symptoms are.

As warming ointments and compresses used as a pharmacy ("Collagen Ultra"), and means prepared at home.

Treatment of bursitis may also include the following physiotherapy procedures:

• Irradiation with ultraviolet;
• UHT - treatment with acoustic waves;
• Inductothermy (use of a magnetic field);
• Electrophoresis (introduction of a drug with a current);
• Paraffin-ozocerite applications.

All these actions are aimed at activating the metabolic processes of the body. Assign them strictly individually, in accordance with the symptoms of the disease.

To reduce pain in the treatment of bursitis, and to remove the edema, a therapeutic massage is performed, which can be easily carried out at home.

The joint affected by bursitis is fixed in a stationary state with the aid of an elastic bandage or gypsum longi. You can use a bandage or a tire.

Massage is carried out directly through clothing with an ice pack.

Surgery

In acute bursitis of the ulnar process of infectious etiology, the contents of the bursa are removed by means of a cut and installation of drainage. This method prevents the development of osteomyelitis. Antimicrobial therapy (cephalothin, oxacillin), will stop the spread of infection.

Chronic bursitis leads to surgery. The fact is that calcium deposits, arising over time, bring a lot of inconvenience. Small deposits are removed with a needle (aspiration).

Purulent bursitis leads to the removal of part of the periarticular bag. In extreme cases, the bag is removed completely (bursectomy).

In no case can not dissect the exudate at home yourself! This is fraught with a fatal outcome.

Traditional methods of treatment

Simple homemade recipes greatly facilitate the treatment of bursitis and lead to a speedy recovery. Several recipes for cooking at home:

1. Saline compress, for example, helps the release of accumulated fluid and alleviates the symptoms of the disease. Tablespoon dissolve in, liter of boiling water. Soak the dense tissue with this solution and apply a compress on the affected joint site for 8 hours. Wrap up the film, insulate.
2. Cabbage compress - anesthetizes and relieves inflammation, good antiseptic. A wide leaf of fresh cabbage, freed from veins, be discarded with a wooden hammer or rolling pin until the juice appears. Inflict the affected joint with a small layer of honey and cover with a prepared cabbage leaf. Wrap it up.
3. Honey ointment has a resolving effect. Mix honey, alcohol and aloe juice ( 1). Apply to painful joints twice a day.

The timely treatment of bursitis gives a chance to cure the disease in a week.

More complex cases are treated longer, and complete improvement of the state of health with the disappearance of symptoms occurs no earlier than 3 months.

The patient is prescribed therapeutic exercises with a gradual increase in the load. Recommendations are given on carrying out preventive measures at home.

A source: http://sustavlive.ru/drugie-bolezni/bursit-lechenie.html

Bursitis

Bursitis is an acute, subacute or chronic inflammatory process in the synovial bag. The disease is accompanied by an increase in the bag due to the accumulation of exudate therein.

The cause of development can be acute trauma, permanent mechanical irritation or deposition of salts in certain rheumatoid diseases. About 85% of all cases of bursitis occur in men.

The first place in terms of prevalence is occupied by the ulnar bursitis.

Anatomy

A synovial bag is a slit-like cavity lined with a shell and containing a small amount of synovial fluid.

Bags are located near the protruding sections of bones and perform a damping function, protecting soft tissues (muscles, tendons, skin and fascia) from excessive friction or pressure.

Allocate the following types of synovial bags: axillary (located under the muscles), subfascial (located under the fascia), subconscious (lying under the tendons) and subcutaneous (located on the convex surface of the joints, directly in the subcutaneous cellulose).

Classification of bursitis

In traumatology and surgery, there are several classifications of bursitis:

• Given the localization (elbow, knee, shoulder joint, etc.) and the name of the affected bursa.
• Given the clinical course: acute, subacute and chronic bursitis.
• With regard to the pathogen: specific (bursitis with syphilis, tuberculosis, brucellosis, gonorrhea) and nonspecific bursitis.
• Taking into account the nature of the exudate: serous (plasma with an admixture of a small amount of formed blood elements), purulent (microorganisms destroyed cells, decayed leukocytes), hemorrhagic (a liquid with a large number of erythrocytes) and fibrinous (with a high content of fibrin) bursitis.

In addition, aseptic (uninfected) and infected bursitis is often isolated in clinical practice.

Acute infected bursitis usually develops as a result of a minor injury (small wound, hematoma, abrasions) or purulent inflammation (decubitus, osteomyelitis, carbuncle, furuncle, erysipelas inflammation). In the area of ​​damage, pyogenic microbes reproduce, which are then transported along the lymphatic path to the area of ​​the bag, infecting its contents.

It is also possible to carry the infection through the blood or direct entry of microbes into the cavity of the bag in case of soft tissue damage.

Most often, direct infection occurs with cuts and abrasions in the elbow area (for example, as a result of a fall from a bicycle).

The probability of bursitis with a direct hit of microorganisms increases with a decrease in immunity, alcoholism, diabetes, steroids, certain kidney diseases.

In addition, the cause of bursitis may be some diseases (scleroderma, gout, rheumatoid arthritis).

In this case, bursitis occurs due to the deposition of salts in the synovial bag.

Chronic bursitis occurs due to a permanent, long-term mechanical irritation of the corresponding area.

Usually its occurrence is due to the peculiarities of professional or sports activity.

For example, miners often have bursitis of the elbow joint, housewives and domestic workers - bursitis of the knee joint, etc.

Symptoms and development of bursitis

With acute bursitis in the area of ​​the bag, a painful, limited, elastic swelling of a rounded shape is formed. There is reddening of the skin and a small swelling of the soft tissues.

The patient is concerned about the pain in the affected area. Sometimes the patient complains of malaise and fever. When palpation is determined fluctuation, confirming the presence of fluid.

Movement in the joint is moderately limited.

With further development of the inflammatory process, edema and hyperemia are intensified, significant hyperthermia (up to 39-40 ° C) and severe pain syndrome are observed.

Sometimes recovery can not be achieved, and acute bursitis passes into a subacute, and then into a chronic form.

With a chronic bursitis in the area of ​​the bag, a soft, limited swelling of the rounded shape is determined. Redness, swelling of surrounding tissues and soreness in palpation are absent. Movements in the joint are preserved in full.

With secondary chronic bursitis, a recurrent course is possible.

In this case, isolated areas of destroyed tissues remain in the cavity of the bag, which, with a decrease immunity or a small injury can become a fertile ground for the re-development of the inflammatory process.

The diagnosis is made on the basis of the clinical picture. To clarify the nature of the inflammatory fluid and determine the sensitivity of microorganisms to antibiotics, a puncture is performed.

During the diagnosis it is necessary to exclude specific infections (spirochaetes, gonococci, etc.), so when bacteriological studies and serological tests are carried out on the basis of the suspected specific nature of the disease. reaction.

Differential diagnosis with arthritis is carried out on the basis of clinical signs: in bursitis, unlike arthritis, the volume of movements in the joint is slightly reduced or preserved.

X-ray diagnostics and MRI of joints are an auxiliary diagnostic method for superficial bursitis and acquire greater practical importance in the recognition of deep bursitis, less available for immediate clinical research.

Treatment of bursitis

With acute aseptic bursitis, the limb rest is calm, ice compresses, anti-inflammatory and anesthetic preparations are prescribed. In some cases, a bursa puncture is performed to remove fluid and / or administer corticosteroids.

When joining the infection, antibiotic therapy is carried out, if necessary, repeated removals inflammatory fluid or drainage with washing of the bursal cavity with solutions of antibiotics and antiseptics. In severe cases, surgical excision of the bursa is sometimes required. Further treatment is carried out as usual with purulent wounds, healing can take a long period of time.

Treatment of chronic aseptic bursitis depends on localization. In many cases, the most reliable way to permanently get rid of bursitis is a surgical operation - excision of the bag.

Recurrences of bursitis with this method of treatment are observed in 2% of patients.

Complications of bursitis

Purulent bursitis can be complicated by fistula, osteomyelitis, arthritis or sepsis.

Bursitis of the elbow joint

As already mentioned above, the most common type of bursitis is the bursitis of the elbow joint, more precisely - the ulnar subcutaneous bag located in the region of the elbow process.

Acute ulnar bursitis develops as a result of trauma, drift of infection or metabolic disorders.

The cause of development of acute and chronic bursitis can be features of labor or sports load (except for miners this disease sometimes people suffer, forced to constantly lean on their elbows on the table while working, as well as wrestlers - due to the pressure and friction of elbows on carpet).

First, a small swelling appears in the elbow region, which often goes unnoticed.

With acute bursitis, the swelling increases, the skin over it blushes, the movements in the joint become painful. There may be a local increase in temperature.

When palpation is determined by the elastic fluctuating formation. With further development of infection, there is weakness, symptoms of general intoxication.

The treatment of acute bursitis is performed by surgeons. Therapy includes standard methods used for all types of bursitis: rest, compresses, anti-inflammatory and analgesic agents, sometimes - punctures and the administration of corticosteroids.

In advanced cases, surgical intervention is performed - opening with subsequent drainage.

With chronic bursitis, the swelling also continues to increase, however, in this case neither redness nor fever is observed. The only unpleasant symptoms may be a feeling of awkwardness in the elbow area and pain when flexing, due to the tension of the bursa.

In the absence of treatment, the bursa can reach considerable dimensions and significantly limit the mobility of the joint.

When doing any work, the patient is forced to take breaks due to pain during movements. The swelling can be both elastic and tense, and flabby, soft.

Sometimes palpation is determined by cartilage density and scarring.

Chronic aseptic bursitis is administered by traumatologists and orthopedists. The punctures of the bag are not shown in this case, since after removal, the liquid usually accumulates again. Operation is recommended.

Surgical intervention is performed in a hospital. The bag is peeled from the skin and bone, and then removed, the wound drained, a tight bandage applied to the joint area.

The graduate is removed on the 2nd or 3rd day, the sutures are usually removed 10 days after the operation.

It should be remembered that with the elbow bursitis there is a sufficiently high risk of secondary infection.

Therefore, the doctor should be treated early, without waiting for complications.

Bursitis of the knee joint

The most commonly affected subcutaneous bag located on the front surface of the joint (first place in prevalence), and an infratellular sac located under the knee cap and large tendon. Prepatellar bursitis is an inflammation of the subcutaneous sac located on the front surface of the knee. Occupies the first place in terms of prevalence among bursitis of the knee joint.

The disease usually occurs after an injury (a fall on the knee cap, a bruise or stroke) or after a long kneeling, usually due to professional activities (knee roofer, knee home mistress). In addition, the cause of bursitis may be the deposition of salts in pseudogout, gouty arthritis or rheumatoid arthritis.

There is swelling, redness of the skin, unpleasant sensations in the knee area. The pain is usually less pronounced than with arthritis, the movements are slightly limited or kept in full.

There may be some stiffness when walking. When infection of the fluid in the bursal cavity pains increase, the volume of movement decreases, there is an increase in regional lymph nodes and an increase in body temperature.

Treatment - as with other types of bursitis.

Infragastellar bursitis develops as a result of inflammation of the infratellular bursa located under the large tendon, which, in turn, lies under the patella.

Usually the cause of bursitis is the injury when jumping (knee jumper).

Treatment includes rest of the affected limb, ice packs, and the taking of painkillers and anti-inflammatory drugs.

Goose bursitis is an inflammation of the goose bursa located on the posterior internal surface of the knee joint. It often develops in overweight women. It is accompanied by pains that increase when climbing and descending the stairs.

Conservative treatment is standard, conducted by surgeons.

In chronic aseptic bursitis goose bag, which is also called Bekker's cysts, recommended surgery - excision of the bursa.

The operation is performed by traumatologists or orthopedists in a hospital. As in the case of elbow bursitis, a rubber graduate is put in a postoperative wound for 1-2 days. Sutures are removed on the tenth day.

Bursitis of Shoulder Joint

The most common inflammation of bags, not associated with the cavity of the shoulder joint - subacromial, fake and subcutaneous acromial. There is pain, which increases when the limb is withdrawn. Pain syndrome is particularly pronounced when bursitis is a counterfeit bag.

The area of ​​the shoulder joint increases somewhat in volume, the contours of muscles are smoothed out. With the defeat of the counterfeit bag, the deltoid muscle appears enlarged, in some cases a swelling appears on the outer surface of the joint.

Bursitis of the hip joint

The ileo-scallop bag, the deep and superficial bag of a large trochanter are most often affected. For these varieties of bursitis is characterized by a heavy current.

Acute bursitis is accompanied by a significant increase in temperature and severe pain, which is sharply increased when the thigh is turned, developed and withdrawn.

The forced position of the limb is observed: the hip is withdrawn, bent and slightly turned outward.

In some cases, bursitis of the hip joint should be differentiated from purulent arthritis. In contrast to arthritis, bursitis is characterized by the presence of local swelling, the absence of pain with axial load on the limb, reduction and flexion of the hip.

Bursitis of the ankle

Most often in this area there is bursitis of the subcutaneous calcaneus sac located between the Achilles tendon and the calcaneal tubercle.

The cause of the occurrence is trauma (for example, rubbing shoes) or the transfer of infection through the lymphatic or blood vessels.

Sometimes, in cases of achillobursitis, differential diagnosis should be performed with an inflammatory process caused by traumatization of the tissues with a calcaneal spur.

Prevention of bursitis

Miners and people of other professions, associated with an increased risk of bursitis development, should ability to protect synovial bags from permanent trauma (for example, using protective bandages). To prevent the development of acute bursitis, it is necessary to carefully treat the wounds in the joint region, correctly and timely treat pustular diseases.

A source: http://www.krasotaimedicina.ru/diseases/traumatology/bursitis

Characteristics of bursitis: the essence, causes, types, symptoms and treatment

Bursitis is an inflammation of synovial bags (they are called bursa - small cavities) located in the joint area, which is accompanied by the accumulation of inflammatory fluid in them.

The disease can affect any joint. Much more often inflamed bags surrounding large joints: knee, elbow, shoulder, ankle, hip. Small joints in the area of ​​the fingers and toes are also affected, but less often.

Classical variants of bursitis flow do not carry a particular danger:

• Symptoms such as pain and limited puffiness over the area of ​​the inflamed, periarticular bag cause short-term disability (about 2-3 weeks).
• A pronounced inflammatory process or suppuration of the bursa leads to a longer loss of function of the affected joint.
• With chronic bursitis, the symptoms are minor. There is only a cosmetic defect in the form of a small tumor.

Bursitis never leads to permanent disability or disability.

Treat this disease orthopedists, traumatologists and surgeons. In most cases, conservative therapy is sufficient for a complete cure for bursitis. In the absence of the effect of complex anti-inflammatory therapy, an operation is performed. In all cases, the disease is curable.

Read further in the article: what happens with bursitis, the causes of its development, symptoms and features of treatment.

What happens with bursitis?

The ease of movement in any joint depends, among other things, on the unobstructed sliding of the tendons, which are fixed in the restricted canals in the joint region.

Provide this ability to help periarticular tendon bags - bursa - bag-like closed Cavities covered from the inside by a thin sliding synovial membrane that secretes a specific lubricant liquid.

Click on photo to enlarge

In the area of ​​each joint is located one to several bags. They have different sizes, surrounding the joint along the perimeter. The more anatomically complex and larger the joint - the more synovial burs surround it.

The diagnosis of bursitis - means the presence of inflammation in the periarticular bag.

Primarily, the internal (synovial membrane) of the bursa is always affected: it drips, partially or completely collapses - which entails excessive production of liquid into the bag cavity.

Also, the bag sharply increases in volume and size, which causes the involvement of the surrounding soft tissues, tendons and skin in the pathological process.

Causes of pathology

The causes of inflammation in the periarticular bag with bursitis are:

1. Injuries: prolonged pressure (eg, resting on the knee or elbow), falls and bumps in the area where the bursa is located.
2. Wounds and injuries that directly penetrate into the cavity of the bag or are located only on the skin above it. The cause of inflammation is either mechanical irritation or infection.
3. Chronic joint overload due to the peculiarities of professional activity or sport.
4. Infections. Disease-causing microorganisms can penetrate by contact in the presence of wounds or suppuration of the skin (furuncles, infected wounds, abscesses) in the area of ​​the affected joint. Perhaps they spread from any foci of infection in the body with blood flow.
5. Diseases of connective tissue of a systemic nature: in this case bursitis occurs with rheumatoid arthritis, gout, lupus erythematosus, scleroderma.

The probability of bursitis increases with:

• reduced immunity;
• diabetes mellitus;
• "Harmful" (for the disease) profession: for example, with a high risk of injury;
• alcoholism;
• severe diseases of internal organs;
• prolonged intake of hormonal drugs.

Common symptoms of bursitis:

(if the table is not completely visible - turn it to the right)

Edema of the right knee with bursitis

Types of bursitis and their characteristic features

It is of fundamental importance to classify bursitis depending on the type of inflammatory process: acute, chronic and purulent - the therapeutic tactics depend on this.

The main criteria for determining the type of bursitis by symptom are given in the table:

(if the table is not completely visible - turn it to the right)

Diagnostics

The clinical picture is enough to make the correct diagnosis. In case of doubt, such examination is appointed:

• The puncture of the inflamed bag is a puncture of the skin in the area of ​​inflammation in order to determine the nature of the accumulated liquid, its seeding for the presence of pathogenic microorganisms and other laboratory tests.
• Ultrasound - visualization (inspection) of the inflammatory process with the help of an ultrasound device. This is a very good method, as it provides reliable information not only about the condition of the periarticular bags, but also other joint tissues.
• Radiography is not informative for the diagnosis of bursitis; it is expedient only if it is necessary to exclude the spread of the inflammatory process to the bone or joint cavity;
• CT and MRI allow you to make an accurate diagnosis, but because of the high cost for diagnosis of bursitis are used extremely rarely.

Methods of treatment

Orthopedic traumatologists and surgeons can treat bursitis. The main rule of the medical process is a complex and individual approach to each specific case of the disease.

Conservative therapy

A complete conservative treatment consists of six components:

1. Providing a patient limb of functional dormancy

The joint in which the inflammation of the bag has arisen must be fixed in a stable position to exclude movements and loads on altered tissues. For this, the following methods are used:

1. pressing bandage of elastic bandage;
2. hard or soft-elastic orthosis (elbow, knee);
3. kosynochnaya bandage;
4. gypsum or longi from the Scotch (special orthopedic material).

Pressing bandage on the knee joint

The basic means by which bursitis is treated are non-steroidal anti-inflammatory drugs.

They must be prescribed to all patients, but taking into account the existing concomitant pathology (with caution apply to people with diseases of the stomach and duodenum).

The most widely used are injection and tablet forms containing diclofenac, meloxicam, nimesulide, ibuprofen, paracetamol.

The need for their use arises rarely due to harmful effects on the body.

But the introduction of glucocorticoids by a short course (2-3 times), especially with severe bursitis, has a powerful anti-inflammatory effect.

3. Puncture of sore bursa

The puncture method allows to cure acute bursitis for the shortest possible time.

Its essence is the puncture of the affected bag with a needle through the skin, which allows to pump out the accumulated inflammatory fluid and insert into the cavity of the bursa the means that stop the inflammation.

Most often, short-acting glucocorticoids (hydrocortisone) and long-acting (kenalog, diprospan) are administered. Such treatment is really effective and does not cause side effects. Contraindicated in purulent bursitis.

Puncture of the bursa of the shoulder joint

4. Antibiotics

Antibiotics prescribe in the presence of signs of purulent bursitis or the absence of a positive effect of the anti-inflammatory treatment.

Use drugs amoxyl, augmentin, levofloxacin, cefuroxime, ceftriaxone.

5. Physiotherapy

Electrophoresis of medicinal preparations, UHF, magnetotherapy, phonophoresis, paraffin applications - supplement the basic therapy. It is possible and necessary to carry out such procedures only after reducing the inflammatory manifestations with an accurate confidence in the absence of a suppuration process.

6. Ointments and compresses

Reduce the swelling and inflammation of the periarticular bag can be applied to her compresses based on alcohol (in dilution: with furatsilinom, saline or novocaine). Effective also compresses with dimexid, which must be diluted:. Such solutions must necessarily be warm.

Supplement anti-inflammatory therapy with topical preparations. These are ointments or gels: nylid, remisid, doloben, diclac, indovazin, fastum, etc.

Surgery

Operate bursitis in two cases:

1. Suppuration of the periarticular bag or surrounding tissue. Conduct a cut of the purulent cavity, removal of purulent liquid contents and excision of nonviable tissues. The doctor necessarily leaves the drainage, which will not allow the wound to prematurely close, so that eventually it can be fully cleared.
2. Formation of chronic bursitis. Such patients completely remove the problem bag, including its capsule, contents and scar tissue.

The entire period of treatment with bursitis takes an average of 1-2 to 4-5 weeks. The forecast is almost always favorable. Relapses of the disease with timely and full treatment (including surgical) are in 2-3% of cases.

A source: http://SustavZdorov.ru/raznoe/bursit-303.html