Articular pathologies include not only diseases of the bone or cartilage part of the joint, but also diseases that affect the periarticular tissues. One of these ailments is bursitis. It is an inflammation of the bursa, or synovial bursa - a closed cavity surrounding the joint and acting as a protective shell in relation to it. The bursa protects joints from damage and increased friction during movement. For this purpose, the membrane contains synovial fluid - a kind of joint lubricant. With bursitis, the fluid becomes inflamed, causing pain and swelling in the joint area. The most common phenomenon is bursitis of the joints of the lower extremities, including knee bursitis. At the initial stage, the symptoms of bursitis of the knee joint can be confused with signs of another articular pathology - synovitis, but as the disease develops, they acquire a specific character.
Athletes, agricultural workers and other people engaged in heavy physical labor know well what bursitis of the knee joint (BKS) is. The knee is one of the most mobile and loaded joints. It supports the body during walking, running, and carrying heavy loads, which causes the joint to experience significant overload. With bruises and increased load, a protective reaction is triggered, and the body increases the production of synovial fluid, which is necessary to lubricate the joint and improve its dynamic capabilities.
But if overloads and injuries to the knee are repeated systematically, excess synovial fluid, which does not have time to be absorbed by the articular tissues, stagnates in the periarticular area and becomes a focus for the development of the inflammatory process. Knee bursitis can also be caused by:
To systematize diseases, a unified International Classification of Diseases was created, in which each pathology known to doctors is designated by an alphanumeric code. The ICD 10 code for bursitis of the knee is M70.
Knee bursitis is a pathology, treatment of which should begin immediately. At an early stage, the disease can be cured quickly, but the advanced form is dangerous due to serious complications, such as purulent arthritis, lymphadenitis (inflammation of the lymph nodes adjacent to the knee), tendobursitis - inflammation of the knee tendon in combination with degenerative changes in the ligamentous apparatus. In the most severe cases, purulent fistulas may form, osteomyelitis, and even blood poisoning may develop.
The synovium surrounding the knee joint is divided into four isolated chambers. Depending on which of them the inflammatory process develops, bursitis is divided into:
There are several classifications of knee bursitis. Due to the development of the inflammatory process, bursitis is divided into septic, resulting from the penetration of pathogenic microorganisms into the synovial bursa, and aseptic, resulting from injury or overload of the knee. The septic appearance can be caused by both exogenous (penetrating from the outside) pathogenic agents, and endogenous ones - entering the bursa from chronic infectious foci in the body.
For another type of classification, the determining factor is the composition and volume of synovial fluid. If, after taking a sample, traces of pus are found in it, a diagnosis of purulent bursitis is made; with a significant increase in the volume of periarticular fluid, we can talk about the serous form; if blood is detected in it, the hemorrhagic variety of this pathology is diagnosed.
Depending on the form of the pathological process, there are four stages of development of bursitis:
Only a doctor can confirm the presence of the disease, determine its stage and prescribe the correct treatment, summing up the results of the examination. Therefore, if pathological symptoms occur, you must immediately seek medical help and begin treatment.
Severe symptoms are characteristic of the acute form of bursitis of the knee joint:
Symptoms and treatment also depend on which area of the synovial bursa is involved in the pathological process. Prepatellar bursitis is characterized by a feeling of stiffness that occurs in the knee joint during a long break in movement, but goes away as it resumes.
Suprapatellar bursitis can be identified by severe pain and swelling at the top of the knee. Anserine (Anserine) bursitis is accompanied by swelling in the back of the knee, which may come and go intermittently, and pain in the joint when moving up or down stairs.
Diagnosis and treatment of knee bursitis begins with an external examination, then general and biochemical blood tests are performed. For instrumental diagnostics, the following techniques are used:
An examination carried out using a thermal imager, which detects areas of increased temperature in the joint area, also helps to determine bursitis.
If during treatment there is a need to find out the nature of infection of the bursa tissue, a sample (puncture) of the periarticular fluid is taken using a syringe. With the serous aseptic form of bursitis, such a test is not done.
The symptoms and treatment of knee bursitis are closely related. How and with what to treat bursitis of the knee joint depends on the data obtained by the doctor during the examination of the patient. In most cases, conservative treatment methods are used to treat pathology - primarily drug treatment of knee bursitis. Recommended:
When treating the aseptic form of bursitis of the knee joint, physiotherapeutic procedures are indicated - laser therapy, magnetic therapy, shock wave therapy, paraffin applications.
Traditional healers suggest relieving swelling and pain from bursitis with cabbage leaf compresses. A compress made from crushed Kalanchoe leaves or crushed fresh leaves of common lilac gives a good effect.
In the acute period of the disease, it is advisable to follow a diet with limited consumption of table salt, fatty and fried foods. Lean varieties of meat and fish, eggs, dairy products, fresh fruits and vegetables, as well as natural juices from them are recommended.
Traditional methods of treating bursitis must be combined with drug treatment. Before using them, you should consult your doctor.
A compress with Dimexide has a good therapeutic effect for bursitis of the knee joint. For treatment, you need to mix one spoon of this remedy in the form of a solution with the same amount of water, moisten a piece of bandage or gauze in it and apply it to the knee joint. You need to put a piece of plastic film on top and tie it with a warm scarf or scarf. It is recommended to keep the compress for no more than half an hour.
The medicine is contraindicated during pregnancy, cardiovascular pathologies, as well as impaired liver and kidney function. It may have side effects such as skin irritation and itching.
If a large amount of exudative fluid accumulates, the knee bursitis is drained to remove it by inserting drainage tubes into the knee joint area through a small incision. Antibiotics are injected into the joint through these same tubes.
If conservative treatment of knee bursitis does not produce a positive effect for a long time, experts recommend a surgical operation - bursectomy of the knee joint, which is an excision of the synovial bursa.
If the patient does not have serious health problems (diabetes, cardiovascular pathologies), it is performed on an outpatient basis, but in the presence of concomitant diseases, hospitalization is recommended. During the operation, both general and local anesthesia are used, depending on the medical indications and the wishes of the patient.
The operation may take the form of an open transectomy, in which the surgeon makes a large incision through which the bursa is removed and then sutured, or an arthroscopic bursectomy, in which surgical instruments and a micro-video camera are inserted through 5 mm incisions.
The first option requires a longer recovery period (about a week). With arthroscopy, rehabilitation takes half as much time. Here are the reviews patients leave about the bursectomy operation and its effectiveness:
I developed bursitis in my knee after a sports injury that I neglected. I was treated conservatively for five years, but did not notice any positive changes. The attending physician recommended a bunionectomy, warning that after it I would have to forget about sports. I hesitated for a long time, but then I decided. It was done under local anesthesia. A week later I was discharged from the hospital, limping for about a month, but then it became easier. Now my leg doesn’t hurt, I walk normally, I went back to work, although the mobility of the joint has not yet fully recovered (three months have passed). The doctor prescribed exercise therapy (physical therapy), but I don’t have enough time or patience to do it.
Treatment for knee bursitis should begin as early as possible. Only in this case can doctors guarantee a lasting positive result.
Bursitis is an inflammation of the synovial membrane, which is accompanied by increased formation and accumulation of exudate in the cavity of the synovial bursa.
It should not be confused with synovitis, which is inflammation of any synovial membrane. Bursitis is a separate type of synovitis (we can say that it is synovitis of the synovial bursa).
The synovial membrane covers the protruding areas of bones and soft tissues (skin, fascia, tendons, muscles). And bags are called narrow slit-like cavities that are located between two synovial membranes. They belong to the auxiliary formations of the musculoskeletal system and produce synovial fluid.
The latter performs a number of very important functions: it is involved in the delivery of nutrients and oxygen to the joints and muscles; in the event of an infectious process, it contains a number of anti-inflammatory components, some cellular elements, immunoglobulins and other substances.
According to their location, the joint capsules are divided:
Most synovial bursae are located in the area of large and mobile joints: shoulder, knee, hip. Therefore, when inflammation occurs in these joints, bursitis often develops. Such synovial bursae play a shock-absorbing role, reducing pressure and softening friction when the limb moves. Some of them may communicate with the joint cavity (for example, the patellar bursa), and this is another factor contributing to their inflammation in arthritis.
Bursitis can occur in both permanent and newly formed bursae in places of constant friction and pressure of the skin, fascia, muscles, tendons on bone protrusions. Therefore, synovial bursae are more often involved in the inflammatory process in arthritis of the elbow or knee joints.
Not only bursitis can be a complication of arthritis. Having arisen primarily in the synovial membrane, inflammation can spread to the joint tissues, leading to arthritis. Thus, the opposite also happens.
When bursitis occurs, the synovial membrane begins to produce exudate. This is a fluid formed during inflammation, containing a large amount of protein and blood cells.
The causes of bursitis can be:
Based on the above, bursitis occurs most often with traumatic and infectious arthritis.
Diagnosis begins with an examination by a specialist and identification of the symptoms described above.
The main differential diagnosis of bursitis is with arthritis. We should also not forget that these processes often accompany each other. The main distinguishing feature is the preservation of movement in the joint. But with deep bursitis it can be somewhat limited, as with arthritis.
Diagnosis of superficial (subcutaneous) bursitis usually does not cause difficulties, since they are easily accessible to inspection. When salts are deposited in the cavity of the bursa, uneven formations of bone density are palpated. In chronic bursitis, as a result of prolonged inflammation, fibrosis of the capsule of the synovial bursa develops; upon palpation, dense formations similar to a scar are determined.
X-ray examination is used to identify deep bursitis. It also helps differentiate them from arthritis. Most often it is necessary to take x-rays for bursitis in the area of the knee joint, greater trochanter of the femur, ankle joint, subcalcaneal mucous bursa, subacromial bursa. Arthro- and bursography, ultrasound and radionuclide studies are used as additional methods.
Another diagnostic procedure is puncture of the affected bursa. It helps to establish the nature of the exudate (serous, purulent, hemorrhagic, mixed). By culture, serological and other methods, it is possible to identify the specific pathogen that caused the inflammation and establish its sensitivity to antibiotics. First of all, exclude a specific infection (tuberculosis, brucellosis and others) that requires special treatment.
Laboratory tests are required to identify inflammatory changes in general and biochemical blood tests and other tests.
The puncture can also be of a therapeutic nature and used to wash the cavity of the bursa with antibacterial drugs and administer medications.
The acute process begins with the formation of serous exudate, its accumulation in the cavity of the bag and saturation of the surrounding tissues. Further, in the presence of an infectious agent, it becomes purulent. The latter quickly spreads to the surrounding tissue, causing necrosis of the synovial membrane with the formation of subcutaneous and intermuscular phlegmon. The outcome may be the formation of long-term non-healing fistulas (i.e. the formation of “channels” that open to the surface of the skin, through which purulent contents come out).
The most common causative agents of infectious bursitis are staphylococci, streptococci, and less commonly - gonococci, pneumococci, mycobacterium tuberculosis, Escherichia coli, and Brucella.
If the process is traumatic in nature, then the exudate becomes hemorrhagic. This occurs because red blood cells enter it from damaged blood vessels. With this option, fibrin begins to appear in the exudate, which is organized, clogging the damaged vessels of the synovial membrane. Subsequently, the wall of the bursa thickens, its surface is covered with growths of connective tissue (proliferating bursitis), dividing the cavity of the bursa into additional pockets.
In the stage of reverse development of inflammation in acute and subacute bursitis, necrotic areas of tissue covered with a capsule or exudate appear in the walls and pockets of the bursa. With repeated inflammation or injury in the same place, the process can easily resume (recurrent bursitis). If the cause of bursitis is a tuberculosis infection, then the walls of the bursa thicken, and microscopy can reveal tuberculous tubercles (specific granulomas) in them.
In the wall of the bursa cavity, deposition of salts (calcium, urates, hydroxyapatites) may begin, which leads to the formation of calcareous bursitis.
After relief of signs of acute inflammation, alcohol compresses are prescribed at night, physiotherapeutic procedures (hydrocortisone phonophoresis, UHF therapy, UV irradiation).
The prognosis may be different depending on the severity of the process, its localization, prevalence, the nature of the infectious agent, and the characteristics of the patient’s body. Even with proper and timely treatment, relapses are possible.
If bursitis is complicated by arthritis, the course can be severe and the outcome unfavorable.
Prevention measures include:
When elbow bursitis is diagnosed, the symptoms and treatment of the disease depend on its severity and the presence of concomitant pathologies. Many people ignore the body’s first signals of problems. Soreness with movement and slight swelling are often not a cause for concern. However, it is early diagnosis and timely therapy that can quickly cure bursitis. Its chronic form reduces the ability to work and significantly worsens the quality of life.
Bursitis of the elbow joint is a disease that is characterized by an inflammatory process in the synovial bursa and the accumulation of exudate in it. The Latin name for the synovial bursa - bursa synovialis - gave its name to the disease. Its international code according to ICD 10 is M 70.3. Bursitis refers to soft tissue diseases associated with stress, overload and pressure.
Exudate is the liquid formed during the development of an inflammatory reaction. It is rich in protein and contains formed elements of blood. The bursa is a slightly flattened cavity - a sac. It is attached to the bones that form the joint near the edges of the articular surfaces or at some distance from them. The bursa hermetically covers the joint, protecting it from mechanical stress and infectious lesions. The synovial bursa is separated from the tissues surrounding the joint by a capsule and filled with synovial (articular) fluid.
The inside of the synovial bursa is lined with synovial membrane. The matrix of the synovial membrane is based on collagen fibers and elastic networks. They form a thin fibrous frame. The upper integumentary layer of the synovial membrane is organ-specific to the joint. Its cells (synoviocytes) produce hyaluronic acid. This component of synovial fluid gives it lubricating properties.
The elbow joint is made up of three bones - the humerus, radius and ulna. It is formed from three simple joints:
The elbow joint contains:
All three bursae are located in the joint capsule, which is common to all three bones.
Elbow bursitis provokes the deposition of salts on the walls of the joint sac. Synovial fluid contains a significant amount of calcium salts. They help cartilage maintain elasticity and promote rapid healing of microtraumas. As inflammation develops, calcium salts accumulate and are deposited in the form of dense formations. Calcium deposits cause joint dysfunction.
Traumatic bursitis is caused by trauma. The inflammatory process occurs immediately after a fracture or dislocation of the elbow. The disease can be caused by sprained or torn ligaments.
Post-traumatic inflammation in the synovial sac develops against the background of changes caused by injury. Often the disease is diagnosed during the rehabilitation stage after an injury.
Traumatic and post-traumatic bursitis is classified as aseptic. In the aseptic form, infectious agents are not found in the joint cavity.
Infected bursitis appears after pathogenic microorganisms penetrate the bursa. Most often, gonococci and staphylococci provoke inflammation of the synovial sac. Antibiotics for bursitis of the elbow joint of an infectious nature are a mandatory component of therapy.
Infectious bursitis is divided into specific and nonspecific. Specific diseases include diseases caused by gonorrheal, brucellosis, tuberculosis and syphilitic infections. When elbow bursitis is diagnosed, how to treat it depends on the type of infection.
Bursitis of the elbow joint is distinguished according to its clinical course. They are acute, chronic and recurrent.
There is an additional classification of bursitis of the elbow joint according to the nature of the exudate.
Inflammations of the synovial sac are: serous, purulent, fibrous and hemorrhagic.
Photo. Subcutaneous swelling in elbow bursitis
There are also mixed types of bursitis (serous-fibrous or purulent-hemorrhagic).
No matter where elbow bursitis occurs, the causes are primarily associated with regular physical activity. The disease is usually found in people who put a lot of stress on the joint during sports training or during professional activities. Regular physical overload is accompanied by minor injuries, which over time trigger a pathological process in the joint.
The disease develops in people who are forced to perform monotonous actions with the elbow joint. It is diagnosed in:
Students and students who are forced to manually rewrite a large number of texts complain about inflammation of the synovial sac. The disease occurs in programmers and pianists.
In this case, the subcutaneous synovial bursa of the olecranon is usually affected. It is located in the place where the skin is most stretched when the elbow is bent. Bursitis of the radiohumeral bursa is less commonly diagnosed. This inflammation is more often found in athletes who perform movements using the elbow joint (tennis players, basketball players, hockey players, javelin throwers, boxers).
The likelihood of developing the disease increases with age. The pathological process is provoked by endocrine, inflammatory and autoimmune diseases, often occurring after 45–50 years:
Negatively affects the condition of the synovial bursa:
During an allergic reaction, a large number of antibodies appear. In the acute phase of the immune response, inflammatory mediators are released and the inflammatory process starts.
The main symptom of elbow bursitis is swelling. It occurs very first and worries the patient the most. Sometimes the synovial bursa of a joint, stretched from excess exudate, is the only manifestation of the disease. As the disease progresses, the joint swells and its capsule clearly bulges outward.
The tumor is clearly visible in the elbow area when the arm is extended. Depending on the stage of the disease, the swollen bursa may resemble the shape and size of a small pillow, plum, or apple. The skin in the area of inflammation sometimes turns red. Redness indicates the infectious or autoimmune nature of the disease.
Deformation of the elbow joint forces the sick person to hold his arm in a forced half-bent position. It is not the stretched bursa that bothers him so much as the pain. It can be shooting, aching or pulsating. Often the pain radiates to the arm. They intensify during night rest. The stronger the inflammation, the more intense the pain. It restricts movement, preventing the elbow from straightening. Motor activity is also impaired due to the deposition of calcium salts.
If the inflammatory process has not gone beyond the synovial bursa, an increase in temperature and intoxication, as a rule, is not observed. In severe cases of the disease, the elbow and axillary lymph nodes may enlarge and become painful.
If bursitis of the elbow joint is suspected, treatment should begin with immobilization of the arm. The joint is fixed using pressure or kerchief orthopedic bandages. For severe injuries, a plaster splint may be used. Sometimes, after a short period of rest, the pain in the elbow joint subsides on its own; no medications are required.
If the swelling is small, Vishnevsky ointment or blood circulation enhancing agents Finalgon and Fastum are used to reduce it. The medicine is applied to the inflamed joint. It cannot be used in acute forms of the disease. It may cause increased swelling.
Non-steroidal anti-inflammatory drugs (NSAIDs) are used to relieve pain and reduce inflammation. If a small amount of fluid has accumulated in the synovial sac and there is no severe pain, use external medications in the form of ointments (Ibuprofen, Diclofenac). They are applied to the inflamed joint (if there are no open wounds on the skin).
When symptoms become severe, the patient takes NSAIDs orally. The tablet is taken after meals to reduce the negative impact on the digestive system.
Treatment of bursitis of the elbow joint is carried out using:
In the first days of therapy, intramuscular injections may also be prescribed. They are recommended for patients with pathologies of the gastrointestinal tract. Severe pain is eliminated with intra-articular injections of NSAIDs or hormonal drugs. Doing them yourself is prohibited. An intra-articular injection can only be entrusted to an experienced surgeon. Antibiotic treatment is prescribed exclusively for purulent bursitis.
After stopping the acute process, physiotherapy is used:
UHF procedures are carried out simultaneously with drug treatment. Radiation therapy is sometimes used to achieve analgesic and anti-inflammatory effects.
To speed up recovery, the patient is prescribed a vitamin complex, calcium supplements and immunostimulating medications. Calcium deposits are dissolved with magnesium preparations.
In case of severe exacerbation, exudate is removed from the bursa using a syringe (aspirated). Aspiration is carried out exclusively under sterile conditions. After removing the exudate, a hormonal drug that relieves inflammation (Kenalog) is injected into the bursa.
If purulent bursitis is detected, drainage of the synovial cavity is used. During surgery, a small incision is made in the wall of the synovial bursa. Through the hole made, the exudate comes out freely. Sometimes a tube is inserted into the wound so that it does not close and does not interfere with the outflow of fluid.
While drainage is taking place, the patient is in the hospital under observation. Rinsing of the drained cavity may be prescribed. The duration of drainage and the number of rinses are determined by the attending physician depending on the severity of the disease.
In advanced cases, when the pathological process develops over a long period of time, the walls of the synovial bursa change, thicken and form folds. The deformed joint is constantly inflamed and makes it impossible to perform daily activities. Your doctor will tell you how to treat elbow bursitis in such cases. A bursectomy (removal of the bursa) may be recommended. During the operation, the bursa is removed, the surface of the olecranon is smoothed and the skin is sutured. During the rehabilitation process, a new bursa is formed in the elbow joint.
Bursitis of the knee joint is an inflammation of the synovial bursa (or bursa). A small cavity is filled with a limited amount of a special fluid that reduces friction in the joint. In severe cases of bursitis, pus accumulates in the membrane and a pathological process develops.
Inflammation of the synovial bursa is a consequence of the negative influence of several factors. There are several “pockets” of fluid near the knee joint, and in any of them an unpleasant phenomenon such as bursitis can occur. Let's figure out what kind of disease this is, why inflammation develops, what treatment methods are effective.
Serous fluid mixed with pus and blood accumulates in the synovial bursa in the following cases:
People of certain professions are at risk. Bursitis often affects football players, weightlifters, loaders, ballet dancers, support workers, hockey players, and tennis players. During “sedentary” work, problems with the knees are also possible due to blood stagnation and worsening venous circulation.
Learn more about the common symptoms and treatments for shoulder tendonitis.
A selection of effective recipes for the treatment of arthrosis of the fingers using folk remedies can be seen on this page.
Types of disease according to the composition of synovial fluid:
Classification of knee bursitis by location:
The course of the inflammatory process:
Contact a rheumatologist, traumatologist, arthrologist or orthopedic surgeon. The doctor will analyze the clinical signs and find out the cause of the negative manifestations. Sometimes consultation with an endocrinologist or infectious disease specialist is required.
How to treat bursitis of the knee joint? Patients do not always seek medical help in a timely manner and often ignore specialist recommendations. Unfortunately, chronic bursitis is a common phenomenon. An integrated approach to therapy plus the patient’s discipline will help cure joint pathology.
Effective medicines:
Home remedies help with the aseptic and infectious nature of the disease. Agree on the list of formulations made from natural ingredients with your doctor. You need to be especially careful if bursitis is infectious: experiments with irritating compounds and the use of hot compresses worsen the course of the pathology.
Learn more about the symptoms and treatment of various knee meniscal injuries.
Effective methods of treating synovitis of the knee joint with folk remedies are described on this page.
Go to http://vseosustavah.com/bolezni/artrit/golenostopnyj.html and read about how to treat ankle arthritis.
Effective methods eliminate congestion in the damaged joint, activate metabolism, and reduce muscle tissue tension. Before prescribing physical procedures, the doctor examines the patient’s condition and adjusts therapy methods.
The following procedures help with bursitis:
After a course of physiotherapy, the stage of physical therapy begins for dosed loading on the problem area. For bursitis of the knee joint, massage is effective in restoring tissue elasticity.
An old tumor does not respond well to conservative treatment, and relapses of chronic bursitis often torment the patient. In the absence of progress in the treatment of a sluggish inflammatory process, doctors offer a radical solution to the problem - surgical treatment.
How is the operation performed for moderate severity of bursitis:
Severe degree of bursitis of the knee joint:
Osteotomy is performed when inflamed tissue affects the connection of bones in the knee joint:
There is another type of operation using a minimally invasive technique. In some patients, calcifications accumulate in the problem joint - dense formations that reduce the mobility of the knee and limb as a whole. Calcium salts in excess quantities worsen the condition of bone tissue and provoke the formation of hard deposits. To remove calcifications, the doctor uses a syringe with a needle of a sufficiently large diameter.
In medical practice, there are several more effective methods for treating knee bursitis. Find out about them by watching the following video:
In addition to the term “bursitis”, which reflects the inflammatory process in the periarticular tissues, you can hear synonymous diagnoses: “valgus deformity of the thumb”, “bones”, and even “bumps on the thumbs”. Doctors call this a process that leads to deformation and disruption of the congruence of the articular surfaces of the base of the big toe, disruption of the integrity of the joint capsule, with the development of aseptic inflammation and disruption of the supporting function of the foot.
Bursitis of the big toe is a polyetiological disease. There is no single reason that can lead to this particular pathology.
Among the most likely causes and risk factors are:
The most common cause directly leading to the clinical picture is hallux valgus, flat feet, arthritis and arthrosis.
You also need to take into account many factors that can lead to increased load on the arches of the feet and disruption of gait biomechanics. So, this is facilitated by obesity and post-traumatic shortening of the limb.
As can be seen from the above, there are many causes, and correct determination of the etiology of inflammation allows you to cope with it faster than when the cause of bursitis remains unknown. What forms of the disease can exist?
First of all, there are acute and chronic bursitis of the big toe:
There is also a subacute form, which occurs with periodic exacerbations and remissions.
In any case, after the first acute attack of bursitis, if a relapse occurs again, and especially against the background of a normal foot configuration, you need to start looking for the cause, since there is a high risk of not only chronicization of the process, but also the occurrence of bursitis in other localizations (for example, with a significant increase in calcium levels in the blood with hyperparathyroidism).
Bursitis can be aseptic (sterile) or infected. The overwhelming number of cases of pathology in this localization are not infectious in nature. However, cases of microbial infection may also occur. This is usually facilitated by a chronic injury to the big toe due to decreased immunity (diabetes, alcoholism). In this case, inflammation is caused by nonspecific pyogenic flora (streptococci and staphylococci).
But with a pronounced decrease in immunity, with concomitant disorders of the peripheral circulation of the lower extremities (obliterating endarteritis) and the presence of chronic ischemia of the feet, conditionally pathogenic flora can be sown from the bursa. Such bursitis is characterized by a sluggish but steadily progressive course, and often ends in an ascending uncontrolled infection.
But sometimes a purulent process in the area of the thumb occurs as a result of transfer from other tissues and organs (lymphogenous, hematogenous) and other means. Bursitis can complicate the course of erysipelas, furunculosis, and itself be a source of purulent-septic complications.
Quite rarely, bursitis of the thumb is caused by a specific infection - chlamydia, the causative agent of syphilis, Brucella or Borrelia. Most often, it still occurs with suppuration due to nonspecific contamination by ordinary flora.
This classification is more applicable to bursitis of large joint capsules, where the volume of punctate obtained can be significant. However, excess exudate due to inflammation of the thumb bursa, despite its insignificant volume, can be of the following nature:
Outcomes for different types of exudation are also different. The presence of serous exudate is most favorable. With fibrinous exudate, limited mobility of the big toe joint may occur due to “sticking” of the walls of the bag.
Of course, no one has died directly from bunions. But you need to know all the signs of this disease in order to consult a doctor in a timely manner.
The following are the classic signs of acute bursitis:
These symptoms are nonspecific, but over time, with increasing hallux valgus and with the development of chronic inflammation, signs such as:
All these symptoms eloquently indicate the progression of the process, and the doctor can make the correct diagnosis based on anamnesis, questioning and examination. What additional diagnostic methods are required to clarify the stage and causes?
For some reason, it is generally accepted among non-specialists that an MRI should be done immediately.
This is not true; first you need to undergo the following examination:
Any material is sent for bacteriological testing to determine the sensitivity of the sown culture to antibacterial agents.
How to treat bursitis? It all depends on the stage of the disease, the severity of the deformity and concomitant pathology. If the deformation has reached large values, then planned orthopedic surgery is recommended, and if there is a purulent form, then bursitis of the thumb should be treated only promptly, and for urgent reasons.
The basic principles of conservative treatment of uncomplicated acute and chronic bursitis include:
Note: acute bursitis should not be heated. Severe swelling will occur, which will increase the pain!
For chronic bursitis, the main methods of treatment are physiotherapeutic and orthopedic, aimed at preventing exacerbation:
If significant deformation of the big toe occurs, treatment should be prompt, in an orthopedic surgery clinic. This will avoid permanent foot deformation and disability of the patient, and a significant decrease in quality of life.
The main indications for orthopedic surgery are:
The most popular operations are bursectomy, in which the inflamed bursa is removed, and osteotomy, which has more than 70 types of execution.
Treatment with folk remedies is possible only for uncomplicated acute processes, for example, wrapping a burdock leaf can relieve pain and swelling. Not a single folk remedy can stop the progressive hallux valgus, as well as the breakthrough of pus into the cellular spaces and synovial vagina of the foot, so you need to urgently consult a doctor.
Bursitis of the big toe, the treatment of which does not involve prevention, will certainly become recurrent. Such measures include:
For those patients who suffer from gout, preventive therapy with Allopurinol is recommended to reduce uric acid levels; for diabetes mellitus, consultation with an endocrinologist and maintenance of normoglycemia are required. It is also necessary to cure all foci of infection in the body and increase the tension of the immune defense systems.
In conclusion, it should be noted that a healthy lifestyle, losing excess weight, and proper nutrition will allow you to avoid metabolic changes that lead not only to bursitis, but also to more dangerous diseases.