Ultrasonographic evaluation of the anatomy and common pathologies of clinically important bursae (2023)

FAQs

Can you diagnose bursitis with an ultrasound? ›

Imaging tests.

X-ray images can't positively establish the diagnosis of bursitis, but they can help to exclude other causes of your discomfort. Ultrasound or MRI might be used if your bursitis can't easily be diagnosed by a physical exam alone.

A major ultrasound sign of bursitis is the enlargement of a bursa, with an increased amount of fluid within it, which can be anechoic in some cases. In other cases, increased echogenicity is apparent due to debris, blood in acute trauma, or puss – if infection appears.

The most bursa in the human body are synovial bursae, which are most common near large joints in the extremities, are located between tissues, and are defined as thin, synovial membrane sacs. [5] A capillary film of synovial fluid on the inner surface of the sac surfaces acts as a lubricant.

On MRI, the bursa is seen as a high T2 fluid-filled structure. CT shows the inflamed bursa as hypodense with an enhancing wall. Clinically, bursitis mimics several peripheral joint and muscle abnormalities.

Septic (or infectious) bursitis occurs when infection from either direct inoculation (usually superficial bursa) or hematogenous or direct spread from other sites (deep bursa involvement) causes inflammatory bursitis. Septic bursitis can be acute, subacute, or recurrent/chronic.

Disabling joint pain. Sudden inability to move a joint. Excessive swelling, redness, bruising or a rash in the affected area. Sharp or shooting pain, especially when you exercise or exert yourself.

Symptoms of septic bursitis include pain over the affected bursa, joint stiffness, swelling, localized tenderness, and fever. If the infected bursa is close to the skin's surface, the overlying skin may be red and feel warm to the touch.

Bursitis is inflammation of a bursa, a closed, fluid-filled sac that works as a cushion and gliding surface to reduce friction between tissues of the body. The most common causes of bursitis are injury or overuse, but it can also be caused by infection.

What are the 4 types of bursae? ›

Common types of bursitis include prepatellar, olecranon, trochanteric, and retrocalcaneal.

Chronic pain: Untreated bursitis can lead to a permanent thickening or enlargement of the bursa, which can cause chronic inflammation and pain. Muscle atrophy: Long term reduced use of joint can lead to decreased physical activity and loss of surrounding muscle.

Bursa Drainage and Removal

If a bursa becomes inflamed and does not respond to medical treatment of bursitis, a surgeon may recommend a procedure that drains excess fluid from the bursa or removes the inflamed bursa altogether.

The bursa is typically not removed unless other treatments haven't improved the symptoms enough after several weeks – or the bursitis keeps returning at short intervals (chronic bursitis).

Ischial bursitis can also be mistaken for ankylosing spondylitis, an inflammatory enthesopathy, or other conditions causing sacroiliitis.

The key difference between arthritis and bursitis is the anatomical structures that they affect. Arthritis is a chronic condition that irreparably damages bone, cartilage, and joints, whereas bursitis is a temporary condition that involves the painful swelling of bursae for a time.

Acute bursitis can become chronic if it comes back or if a hip injury occurs. Over time, the bursae may become thick, which can make swelling worse. This can lead to limited movement and weakened muscles (called atrophy) in the area.

Foods that can trigger inflammation may make your pain worse so these are ones to avoid if you can. This includes processed foods (ready meals, sliced meat), caffeine, fizzy juice, sugars (cakes, biscuits etc.), and alcohol.

Doctors may recommend over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to reduce inflammation in the bursa and tendon and relieve pain. These medications are typically recommended for a few weeks while the body heals.

Try glucosamine or omega-3 fatty acids.

Glucosamine is a substance found in cartilage. Research has shown that over-the-counter glucosamine supplements may help inflammation in bursitis.

Can a bursa be cancerous? ›

Cases of malignant bursitis have been reported several times in the literature, though nearly all of the instances involved connective tissue or metastatic tumors. Tumor histologies include osteochondroma,^8,9 malignant fibrous histiocytoma,¹⁰ synovial sarcoma,¹¹ and metastatic breast cancer.

Most of the time, overuse or repetitive movement of a limb causes the tendon to get inflamed or irritated. Other conditions such as autoimmune disease or infections may cause this sort of inflammation as well.

If septic bursitis is left untreated, the fluid inside the bursa can turn to pus. In addition, the infection can spread to the bloodstream and other parts of the body. If the infection spreads, symptoms will become worse and the infection can even become life-threatening.

Elbow bursas can sometimes become infected (septic bursitis). This requires urgent medical attention and antibiotics. The symptoms of septic bursitis include redness, swelling and heat over the elbow and sometimes a fever.

Aspiration. If your doctor suspects that you have an infection or gout in the bursa, he or she might take a sample of the bursa fluid for testing by inserting a needle into the affected area and draining some of the fluid. This can also be used as treatment.

While aseptic (non-infected) bursitis may be a common condition that can be treated at home, septic bursitis is a serious condition that requires immediate medical attention.

The prognosis of bursitis is usually very good. Sometimes adjustment of activities ultimately leads to the best outcome. Infectious bursitis can require surgical resection of the bursa and antibiotics for cure. Gouty and calcific bursitis can often recur, and if chronic, may require excision of the bursa.

For cases of septic bursitis, patients are prescribed antibiotics. Antibiotics will be taken in the form of capsules or tablets two to four times a day and examples include erythromycin, clarythromycin, and flucloxacillin.

The most common bursa injuries in sports are: Trochanteric bursitis: around the outside of the hip. Iliotibial bursitis: around the outside of the knee. Housemaid's knee (prepatellar bursitis): in the front of the knee.

Your provider might use some tests to diagnose bursitis, including: X-rays to rule out other conditions. Ultrasound or MRI (magnetic resonance imaging) to detect swollen bursae. A blood test to look for infection.

What are the stages of bursitis? ›

Bursitis can subdivide into three phases: acute, chronic and recurrent.

Synovitis (or synovial inflammation) is when the synovium of a joint becomes inflamed (swollen).

Bursae are fluid-filled sacs (or sac-like cavities) that exist to protect bones, tendons, and ligaments. They are lined with a connective tissue called the synovial membrane and they contain a lubricating substance called synovial fluid, which provides cushioning.

MRI Scans. MRI is an advanced imaging technique that uses a magnetic field and radio waves to create detailed two- and three-dimensional pictures of soft tissue inside the body. MRI scans provide clear images of inflammation in the affected bursae and tendons and may be used to confirm the extent of an injury.

Computed Tomography Scan (CT Scan)

Diagnosis of hip bursitis

Your doctor might order imaging tests such as x-ray, MRIs, ultrasounds, or bone scans. Ultrasound and MRI specifically are used to confirm the diagnosis when the bursae are too deep for regular inspection.

Consult your doctor if you have: Disabling joint pain. Sudden inability to move a joint. Excessive swelling, redness, bruising or a rash in the affected area.

Common types of bursitis include prepatellar, olecranon, trochanteric, and retrocalcaneal. Most patients respond to nonsurgical management, including ice, activity modification, and nonsteroidal anti-inflammatory drugs.

The most common causes of bursitis are injury or overuse. Infection may also cause it. Bursitis is also associated with other problems. These include arthritis, gout, tendonitis, diabetes, and thyroid disease.

Is bursitis painful? ›

Bursitis happens when the fluid-filled sacs (bursa) that cushion your joints become inflamed. You might have bursitis if 1 of your joints is: painful – usually a dull, achy pain.

ESR, antinuclear antibody (ANA), rheumatoid factor (RF), and anti–citric citrullinated peptide (anti-CCP) tests should all be ordered in cases where autoimmune disease is suspected because these inflammatory disorders can trigger bursitis.

Trochanteric bursitis is inflammation of the bursa (fluid-filled sac near a joint) at the part of the hip called the greater trochanter. When this bursa becomes irritated or inflamed, it causes pain in the hip. This is a common cause of hip pain.

Exercise is often prescribed to improve joint pain, so walking could be a vital part of managing your bursitis symptoms.

Hip bursitis or trochanteric bursitis is a tricky condition. It's sometimes called “the great mimicker” because its symptoms are easily mistaken for other conditions like back pain or gluteal muscle injuries.

Hip bursitis will often get better on its own as long as it is not caused by an infection. To heal your hip bursitis, you will need to rest the affected joint and protect it from any further harm. Most patients feel better within a few weeks with proper treatment.