Managing All Manner of Bursitis Cases

​A bursa, a fluid-filled synovial sack, serves in the body as either a pulley or a cushion, and bursitis, of course, is an inflammatory response that can occur to a bursa. The causes of the inflammatory response can be trauma (direct or overuse), infection, or rheumatologic or crystal-induced disease.​Whether a bursa is deep or superficial ultimately determines the most likely pathophysiology and dictates the most appropriate treatment. Superficial bursae are those closest to the skin, and they are most vulnerable to direct trauma and infection—the prepatellar, infrapatellar, and olecranon bursae. Deep bursae include the subacromial, pes anserine, and trochanteric bursae. The superficial bursae generally serve as cushions, while the deep bursae more commonly function as pulleys.Watch a video of Dr. Mellick treating a patient with subacromial bursitis.Deep bursae are less likely to become infected because they are less vulnerable to the direct inoculation of bacteria that can occur with superficial bursae, but they are more vulnerable to diseases surrounding them. Osteoarthritis of the knee commonly causes pes anserine bursitis, for example, and a partial tear of the supraspinatus muscle or acromioclavicular arthritis can cause subacromial or subdeltoid bursitis. Unfortunately, it is almost impossible to differentiate between subacromial bursitis, rotator cuff tear, or rotator cuff tendonitis.Because the etiologies of the inflammation of deep and superficial bursae are d...
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