They also increase the likelihood of developing bursitis, including hip bursitis. See Diagnosis through Synovial Fluid Analysis. Arthritis Treatment Specialists. What Is Arthrocentesis Joint Aspiration? You are here Types Bursitis. Hip Bursitis Diagnosis share pin it Newsletters. By Marco Funiciello, DO. These drugs may raise blood pressure and increase the risk of getting an infection if a person uses them for too long.
This may result in doctors missing the optimal time frame for some surgical procedures. If a fluid test confirms a bacterial infection, the doctor will probably prescribe antibiotics. They will generally recommend oral antibiotics, but a person may need to take them intravenously in more severe cases. A person with bursitis may have one or more of the following symptoms :. Septic bursitis occurs when an infection causes bursa inflammation.
A person with septic bursitis may have the following additional symptoms:. Many people treat bursitis at home, but if the symptoms are more severe, they should seek medical help.
More severe symptoms include :. Bursitis can result from an injury, an infection, or a preexisting condition such as gout, which can cause crystals to form in a bursa. Physical trauma can irritate the tissue inside the bursa and cause inflammation. This trauma may occur due to an impact injury or overuse of the joints, tendons, or muscles near the bursa. Overuse is typically the result of repetitive movements.
Infectious bursitis tends to occur in bursae that are nearer the surface of the skin, such as those near the elbow. A cut on the skin is an opportunity for the bacteria to get in. As with other forms of bursitis, repeated trauma and the overuse of joints near bursae are the most common causes of infectious bursitis. However, people with conditions that affect the immune system may have a higher risk of developing bursitis through an infection. People with certain health conditions are more likely to have crystals form inside the bursa.
The crystals irritate the bursa and make it swell. Conditions that may cause bursitis include gout, rheumatoid arthritis, and scleroderma. A doctor will diagnose bursitis by examining the affected area and asking the person about any recent activities that may be causing joint stress. Cellulitis Cellulitis Cellulitis is acute bacterial infection of the skin and subcutaneous tissue most often caused by streptococci or staphylococci.
Symptoms and signs are pain, warmth, rapidly spreading erythema For suspected infection, empiric antibiotics effective against S. Staphylococcus aureus is the most pathogenic; it typically causes skin infections and sometimes pneumonia, endocarditis, and osteomyelitis Subsequent choice of antibiotic is determined by results of Gram stain and culture. Infectious bursitis requires drainage or occasionally excision in addition to antibiotics. Acute nonseptic bursitis is treated with temporary rest or immobilization and high-dose NSAIDs and sometimes with other analgesics.
Voluntary movement should be increased as pain subsides. Pendulum exercises are helpful for the shoulder joint. If oral drugs and rest are inadequate, aspiration and intrabursal injection of depot corticosteroids 0. The same needle is used; it is kept in place and the syringes are changed. Dose and volume of the corticosteroid may vary according to the size of the bursa.
Infrequently, a flare-up occurs within several hours of injection of a depot corticosteroid; the flare-up is probably a synovitis in reaction to crystals in the injection or to needle disruption of calcium deposits. Oral corticosteroids eg, prednisone can be used to treat the primary problem if a local injection is not feasible. Chronic bursitis is treated the same as acute bursitis, except that splinting and rest are less likely to help, and range-of-motion exercises are especially important.
Rarely, the bursa needs to be excised. The usual causes of bursitis are injury and overuse, but infection and crystal-induced disease are possible. Withdraw bursal fluid to diagnose bacterial or crystal-induced bursitis when the olecranon or prepatellar bursa is affected or when there is warmth, redness, tenderness, and pitting edema. If no infection is present, treat most cases with rest, high-dose NSAIDs, and sometimes intrabursal corticosteroid injection.
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