If you experience pain or discomfort in your fingers, visit your doctor immediately
The inflammatory process of the periarticular pocket of the hand is considered a fairly serious illness that requires immediate treatment. Bursitis of the finger is a disease characterized by the appearance of unpleasant symptoms that significantly aggravate the patient’s quality of life, since the victim is unable to carry out simple hand movements due to severe pain.
Inflammation of the synovial bursa occurs due to a mechanical effect on the joint, primarily the bursa is irritated. The inflammatory process of the periarticular pocket does not arise out of nowhere. The prerequisites for its appearance are:
Pianists and people who often have to type on a typewriter or keyboard are most susceptible to the development of this pathology. Also at risk are builders who work with tools such as drills and hammer drills. These devices cause strong vibration, radiating into the fingers and hand, causing damage to the synovial bursa, resulting in an inflammatory process.
The pathological process most often begins to form as a result of injury, muscle strain, or invasion of pathogenic microorganisms. If the disease first appears in a person, it is characterized by an acute course. Signs of the disease appear some time after injury. In medical practice, the following types of bursitis of the fingers are distinguished:
A recurrent type of disease is also distinguished. It is characterized by periodic exacerbations, during which the functioning of the joint is disrupted. Recurrent bursitis requires long-term complex therapy.
The inflammatory process is most often localized in the bursae of the wrist joint. This is due to the high risk of injury. Due to stretching of the muscular and ligamentous frame of the hand, tissue swelling appears, and exudate begins to accumulate in the joint. Symptoms of hand bursitis:
Lack of timely treatment or the addition of a bacterial infection leads to an increase in body temperature up to a febrile state. Fever combined with local inflammation worsens the victim's condition. The patient shows signs of intoxication. He complains of nausea, headache, weakness and hyperhidrosis.
Treatment of bursitis of the finger begins with the use of conservative methods. Acute disease must be treated using the following methods:
If therapy for acute bursitis began too late, other means of conservative treatment should be used. These include medications that can alleviate the patient’s condition, relieve pain and reduce inflammation. For example, NSAIDs, antibacterial drugs, corticosteroid injections. In order for swelling to subside faster, it is recommended to use ultraviolet irradiation, laser, paraffin heating, UHF, and diameter in combination with medications . Treatment with inductotherapy can be started after the acute period has passed.
Treatment of bursitis of the fingers and hands can be carried out using folk remedies that have anti-inflammatory and antimicrobial properties. The best recipes that traditional medicine offers against bursitis:
Treatment with folk remedies is absolutely safe. It can be done independently, without consulting a doctor.
Bursitis is a disease characterized by inflammation of the mucous bursae in the joint area. The disease can be acute or chronic. Elbow bursitis is the most common type.
The disease occurs as a result of inflammation of the synovial bursa, which leads to abundant formation and accumulation of exudate (inflammatory fluid). The causes of bursitis affecting the joints are:
Symptoms characteristic of bursitis depend on the location of the process and are as follows:
Chronic bursitis is characterized by less severe symptoms. With this form, a soft, round-shaped swelling forms in the joint area, without swelling, redness or pain when moving.
It is easier to prevent a disease than to deal with the consequences.
To determine how to treat bursitis, an orthopedic doctor will:
It is necessary to distinguish bursitis from arthritis.
Treatment needed for bursitis includes:
If treatment for the disease is not started in a timely manner, this can lead to the development of a chronic form and dangerous complications:
To prevent the disease it is recommended:
Bursitis is an inflammation of the joint capsule (the word “bursa” itself is translated from Latin as bag). The bursa (or bursa) is where the bones and ligaments touch each other. The bursa, due to the fluid contained in it, softens friction and, thus, provides comfortable movement to the joints. With bursitis, exudate accumulates in the bursa - serous or purulent fluid, and sometimes blood. Inflammation is accompanied by pain and limited mobility of the damaged joint.
Acute joint bursitis may go away on its own in a couple of weeks, but repeated injury to the joint will lead to a chronic course of the disease. In more than 80% of cases, bursitis occurs in men. The joints most susceptible to bursitis are the hip, knee and elbow joints. The most common type is elbow bursitis.
Joint bursitis is classified according to several parameters.
by location: elbow, knee, etc.
by severity: acute, subacute, chronic bursitis or recurrent
according to the composition of the exudate: serous, purulent, hemorrhagic or fibrinous
by pathogen: specific (against the background of serious infectious diseases, such as syphilis) and nonspecific.
Pain and severe swelling of the damaged joint, as well as increased temperature in the sore spot, are the main symptoms of bursitis. Acute bursitis begins with sharp pain at the site of the lesion. For example, with knee bursitis, the pain point may be under the kneecap, and the pain intensifies when flexing/extending the knee. Unpleasant sensations can disturb both during the day and especially at night. Also among the symptoms of acute bursitis: swelling, redness of the skin, general malaise. After bursitis has become chronic, the pain becomes more muted, but constant. Chronic bursitis may cause symptoms of arthritis. Chronic bursitis can be much less bothersome than acute bursitis. But if bursitis is left untreated, its relapses will occur more and more often, and this will inevitably lead to complications.
Bursitis is classified as a group of occupational diseases. The inflammatory process begins with frequent injury or overload of the same joint (for example, in miners). The main risk group also includes athletes for whom professional injuries are inevitable. Joint bursitis can occur even due to a small bruise or wound. A microbe (streptococcus, staphylococcus, etc.) gets into an open wound and inflammation begins. Also, acute bursitis can develop against the background of purulent diseases (furunculosis, erysipelas, osteomyelitis).
Weak immunity, diabetes, and alcoholism increase the risk of joint inflammation. In addition, with some types of arthritis (due to salt deposition), a pathological process can also begin in the joint capsule, which will lead to bursitis.
The prognosis will be favorable if treatment for bursitis is started in a timely manner. The patient is prescribed rest, and a special tight bandage is applied to the damaged joint and compresses are made. Anti-inflammatory drugs and corticosteroids are also prescribed to treat bursitis. Infectious bursitis is treated with antibiotics. For purulent bursitis, surgery is necessary. The surgeon opens the joint capsule to remove purulent exudate. Without surgery, purulent bursitis will certainly lead to complications (including sepsis).
Also, surgical intervention is required for chronic bursitis; the fluid is removed through a small puncture and the cavity of the synovial bursa is treated with antiseptics. Both during the treatment of bursitis, and always after it, it is necessary to develop the damaged joint. Physiotherapy procedures are indicated as restorative and preventive measures for more effective treatment of bursitis: various heating, UHF and UV irradiation, amplipulse, electrophoresis, etc.
At the Belozerova clinic they will help you cure bursitis. To avoid relapses (especially with chronic bursitis), you need to wear a corrective bandage that will prevent further injury to the joint. With a competent approach to the treatment of bursitis, it is quite possible to achieve a final recovery and return to a full-fledged lifestyle.
Bursitis of the joint (Bursitis - lat.) is inflammation of the periarticular (synovial) bursa, accompanied by the accumulation of fluid (exudate).
Bursitis can be caused by infection or injury. Knee and elbow bursitis often occurs as an occupational disease (there are even special terms “jeweler’s elbow”, “watchmaker’s elbow”, “miner’s elbow”, etc.).
Depending on which joint is affected, there are knee bursitis , hip bursitis , elbow bursitis , shoulder bursitis and other types of bursitis.
Joint bursitis is a common disease of the musculoskeletal system. Bursitis is most common among professional athletes and people whose professional activities involve increased stress on the joints.
When bursitis is diagnosed, treatment in integral medicine is complex and carried out individually, including anti-inflammatory and immunomodulatory therapy using medical procedures (acupuncture, acupressure, physiotherapy).
Integral medicine shows the greatest effectiveness in the treatment of chronic and chronic recurrent bursitis.
Treatment goals for bursitis in integral medicine:
- eliminate inflammation, swelling and pain in the joint area,
- restore joint mobility.
Treatment of joint bursitis using integral medicine methods can eliminate the symptoms of the disease, improve the quality of life, eliminate the inflammatory process and prevent the development of complications.
It is also important that if chronic bursitis is diagnosed, treatment in integral medicine is carried out without surgery.
Joint bursitis is an inflammatory disease that can be caused by infection or mechanical damage to tissue (as a result of impacts, friction, regular physical activity). infectious bursitis occurs , in the second case, aseptic bursitis .
The infection that led to the diagnosis of bursitis may occur due to:
In addition, inflammation of the periarticular bursa (bursitis) can provoke, for example, a boil, carbuncle or erysipelas.
Joint bursitis can also occur as a complication of a viral disease (sore throat, ARVI, influenza).
A separate case is calcareous bursitis , which occurs as a result of metabolic disorders in the body and the deposition of salts in the joint capsule. In this case, treatment will include methods of restoring the balance of metabolic processes in the body, taking into account individual characteristics, causes, facts and mechanisms of development of the disease.
Among the reasons why joint bursitis occurs, allergic reactions and intoxication of the body should also be noted. This explains why, when bursitis is diagnosed, treatment using integral medicine methods includes cleansing the body of toxins and waste and improving the functioning of the body’s self-cleaning system (intestinal mucous membranes, lymphatic system, kidneys, liver) - herbal medicine, physiotherapy, reflexology. These methods not only increase the effectiveness of local therapeutic effects, but also provide a long-term and comprehensive healing effect.
Like other types of this disease, bursitis of the knee joint most often occurs due to increased physical activity (for example, with excess weight), injuries (“footballer’s knee”), multiple bruises, abrasions, and also due to the nature of professional activity, namely, prolonged kneeling. In this case, with bursitis of the knee joint they speak of “roofer’s knee”, “parquet floorer’s knee” or “housewife’s knee”.
However, bursitis of the knee joint, like gonarthritis, can also have an infectious cause (septic bursitis).
Unlike arthritis, knee bursitis causes less pain and stiffness. In some cases, bursitis of the knee joint does not limit its mobility. In other cases, pain and stiffness in the knee joint due to bursitis occurs when lifting heavy objects, walking, or kneeling.
Together with bursitis of the elbow and shoulder joints, bursitis of the knee joint is one of the most common types of the disease. Depending on which bursa, or bursa, is inflamed, a distinction is made between popliteal (infrapatellar) bursitis, patellar (prepatellar) bursitis and Baker's cyst (on the inside of the knee). The first two types of knee bursitis usually occur due to injuries (tendons, patella), the third - due to excess weight.
Treatment of bursitis of the knee joint in integral medicine is based on the complex use of physiotherapy and reflexology and in the vast majority of cases shows very high effectiveness, which allows achieving reliable elimination of symptoms and lasting healing results.
When diagnosed with bursitis, the symptoms are determined by the nature and degree of the inflammatory process. The main, most characteristic symptoms of bursitis are swelling and swelling in the joint area, aching or shooting pain in the joint area, limited joint mobility, redness (hyperemia), increased temperature, pain on palpation (pressure).
With a complicated course of bursitis, the increase in temperature can be significant - up to 38-40 degrees, which indicates the occurrence of a purulent process (purulent phlegmonous bursitis). The pain becomes strong and throbbing.
Joint bursitis can occur as an acute, subacute, chronic or recurrent disease. The nature of the exudate may also be different - serous, serous-fibrinous, purulent, purulent-hemorrhagic.
The main complications associated with joint bursitis are purulent arthritis and purulent phlegmonous bursitis. Further progression of the disease can be life-threatening. In these cases, with purulent bursitis, partial or complete removal of the joint capsule may be indicated.
When bursitis is diagnosed, treatment with surgical intervention is indicated only in complicated and most advanced cases of the inflammatory process.
Treatment of chronic bursitis by introducing antibiotics into the periarticular bursa inevitably has negative side effects and does not restore one’s own immune mechanisms. Integral medicine, on the contrary, directs its efforts to improve local and general immunity, stimulating the body's own recovery mechanisms.
Treatment of joint bursitis in integral medicine combines thermal methods with reflexology (acupuncture, pharmacopuncture, acupressure).
When bursitis is diagnosed, treatment with acupressure massage can significantly improve blood and lymph circulation in the joint area, improve nutrition and blood supply to joint tissues, and increase local immunity.
Acupuncture for bursitis helps reduce pain and inflammation, and the use of thermal physiotherapy helps to resolve accumulated fluid (exudate).
Like the treatment of other inflammatory diseases, the treatment of bursitis in integral medicine includes methods that improve immunity. These methods include physiotherapy and reflexology, prescribed as part of an individual treatment course.
The main therapeutic course for the treatment of bursitis can be supplemented with an individual course of physical therapy (physical therapy).
Different types of bursitis have their own characteristics.
The most common type of this disease is shoulder bursitis , or bursitis of the shoulder joint.
Shoulder bursitis manifests itself as pain in the shoulder when moving the arm back, getting dressed, or rotating the arms.
When diagnosed with supraclavicular bursitis, symptoms may be mistaken for glenohumeral periarthritis, which requires differential diagnosis.
Elbow bursitis , or bursitis of the elbow joint, most often occurs as a result of professional activities or intense sports. The pain syndrome is most pronounced during movements of the elbow joint (flexion-extension), the pain radiates throughout the entire arm.
Elbow bursitis is characterized by a significant enlargement of the synovial bursa and noticeable hemispherical swelling.
The same severe swelling is characterized by knee bursitis , or bursitis of the knee joint. In this case, the swelling is accompanied by an increase in the surrounding lymph nodes.
Hip bursitis is most dangerous due to the spread of the inflammatory process to the joint (coxarthritis).
Achilles bursitis is characterized by pain, swelling and redness in the heel and limited mobility of the ankle. This type of bursitis occurs due to inflammation of the Achilles tendon bursa.
Achilles bursitis is especially dangerous due to its complication - the spread of the inflammatory process to the heel tendon and its rupture.
In addition to hematogenous or lymphogenous infection, achillobursitis can be caused by irrational stress on the foot and wearing uncomfortable shoes.
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Bursitis is a common inflammatory disease of the joints that results from overuse or prolonged strain on the joints. The cause of bursitis may be injury to the joint or tendons located in close proximity to it, as well as prolonged tension in it.
Interestingly, treatment for knee bursitis (also called “Maid’s Knee”) is often required for those who spend a lot of time kneeling, for example, while cleaning. In addition, inflammation of the bursa of the knee joint can be triggered by the presence of musculoskeletal diseases such as gout and arthritis in the patient.
Signs that indicate a patient is developing this disease include:
In the early stages of the disease, drug treatment can be very effective. The doctor prescribes the patient to take a specific regimen of antibacterial and painkillers.
Surgical treatment of knee, elbow and other types of bursitis involves, first of all, draining the articular cavity to drain accumulated fluid from it and then rinse it with a disinfecting solution. If there are large calcium deposits in the joint capsule that cause severe discomfort to the patient or interfere with his movements, they are also removed. With long-term inflammation,
The surgery department of our medical center also provides laser treatment for knee and elbow bursitis . This technique involves influencing the affected joints using laser radiation. This helps improve blood supply and metabolic processes in the area of the periarticular bursa and joint. As a consequence of this, the cells are saturated with oxygen, physicochemical reactions and metabolic processes proceed faster in them, pain, inflammation and swelling disappear, rapid tissue regeneration occurs and, as a result, inflammation quickly subsides and treatment time is reduced by 1.5-2 times . In particularly advanced cases, complete removal of the bursa can be performed - the so-called bursectomy.
The surgical department of the UNION CLINIC is equipped with laser equipment that makes it possible to perform other minimally invasive surgical interventions, for example, laser ablation of a breast cyst. You can find out prices for various procedures, as well as make an appointment, by calling our administrators.
or by filling out the online form - the administrator will contact you to confirm your appointment
HELIOS Clinic Berlin-Zehlendorf, founded in 2007, is part of the HELIOS Hospital Group. The multidisciplinary hospital has 13 different departments and treats more than 19,000 inpatients and 69,000 outpatients annually.
HELIOS Clinic Munich West was opened in 2007 as part of the HELIOS Hospital Group. The multidisciplinary clinic has become famous for its oncology and cardiology departments, as well as the Center for the Treatment of Intestinal Diseases.
Over the past decades, as statistics show, international medical tourism has become one of the most developing areas of medicine. The medical tourism market increases its volume by 15-25% annually. There are various types of medical tourism - from recreational tourism, when patients come to relax at resorts, or for check-ups (preventive examination), to the treatment of complex and chronic diseases.
The development of medical tourism , among other things, is due to modern means of communication and the availability of cheap flights has led to the fact that traveling for treatment abroad has ceased to be an expensive privilege available to a few. Today, hundreds of thousands of patients from all over the world have the opportunity to find and compare various treatment options in all corners of the planet.
Favorite medical tourism destinations include Middle Eastern countries , including Israel and Jordan. Israel annually receives about 50,000 foreign patients a year for treatment. Basically, these are immigrants from the countries of the former USSR. Patients come here for treatment of cancer in children and adults, and for cardiac surgery. Also, many are attracted to a health holiday at the Dead Sea.
One of the most popular countries for the treatment of complex and rare diseases is the USA. Highly qualified doctors, the availability of advanced medical technologies and a deservedly excellent reputation of leading clinics - all this attracts foreign patients. But medicine in the USA is one of the most expensive. According to statistics, the number of Americans traveling abroad for treatment is 10 times higher than the number of incoming medical tourists. For treatment in the field of dentistry and orthodontics , or plastic surgery, Americans themselves travel to Mexico, as well as the countries of Eastern and Central Europe (mainly Poland and Hungary), due to the fact that treatment there is cheaper and the quality of medical care is high. service that meets international standards.
Among Asian countries, the leading positions are occupied by Japan, Thailand, South Korea, Singapore, Hong Kong and India . Asian clinics enjoy a good reputation due to the excellent international education of doctors, advanced equipment, caring attitude towards patients and the high quality of medical care in general.
For example, all 12 private hospitals in Hong Kong are Trent (British International Standard) accredited. As for medical tourism in India, the fairly rapid development of this sector has led to India taking second place, after Thailand, in the ranking of receiving countries (in 2015, 2.8 million foreign patients came to Thailand for treatment). Since 2012, according to statistics, the turnover of medical tourism in India has increased by 30% annually.
Last but not least, Europe attracts medical tourists; treatment here is most popular among patients from Ukraine, Kazakhstan, Russia and Belarus. Clinics in Germany, Austria and Switzerland offer treatment for cancer, childhood congenital diseases, rehabilitation after strokes, endoprosthetics and much more.
If you have not yet decided where to go for treatment, MEDIGO will be happy to help you choose the right clinic and specialist in any country in the world.
Bursitis (bursa) translated from Latin means bag.
Bursitis is an inflammatory disease of the synovial bursae, accompanied by increased formation and accumulation of exudate in their cavities.
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According to the clinical course, bursitis can be acute, subacute, chronic, recurrent; by the nature of the pathogen - nonspecific or specific (gonorrhea, brucellosis, tuberculosis, syphilitic); according to the nature of the exudate - serous, purulent or hemorrhagic. Some authors distinguish aseptic and infected bursitis.
Synovial bursae are slit-like cavities formed by the synovial membrane and containing synovial fluid. Synovial bursae belong to the auxiliary apparatus of muscles. They are located in the tissue between protruding areas of bones and soft tissues (skin, fascia, muscle tendons, muscles). The following synovial bursae are distinguished: subcutaneous - located in the subcutaneous tissue on the convex surface of the joint, subject to sharp flexion; subfascial - located under the fascia; subtendinous - located under the tendons; axillary - lying under the muscles. Subtendinous bursae in adults often communicate with the joint cavity. Surrounding the muscle tendon for a considerable extent, they can form a synovial tendon sheath.
Exudate is a liquid rich in protein and containing formed elements of blood; formed during inflammation.
The inflammatory process can occur both in permanent and newly formed bags in places of continuous pressure and friction of the skin, fascia, muscles, tendons on bone protrusions. The most common bursitis is bursitis of the elbow bursae and synovial bursae of the knee and shoulder joints. The frequency of such localization is determined by constant injury to the corresponding parts of the body due to the characteristics of certain sports. This allows us to classify bursitis as an occupational disease. The incidence of bursitis depends on the type of sport and other variables (sports activity regimens, equipment, skill level, etc.).
The cause of acute bursitis is often trauma - bruise, abrasion, minor wounds and secondary infection of the synovial bursa with pyogenic microbes. Infection of the synovial bursae occurs through the lymphatic ducts from purulent foci (with erysipelas, boils, carbuncles, osteomyelitis, bedsores), and infection through the blood cannot be excluded. The possibility of infection due to a cut or abrasion in the area of the joint capsule (falling from a bicycle, playing football) cannot be ruled out. Chronic bursitis is often the result of long-term, constant mechanical irritation. Pathological anatomy. Pathological changes in acute bursitis are expressed by signs of acute inflammation of the walls of the synovial bursa.
The initial stages of acute bursitis are characterized by serous penetration of tissues and accumulation of serous exudate in the cavity of the bursa (acute serous bursitis). In the presence of microbial flora, serous inflammation quickly turns into purulent inflammation (purulent bursitis). The spread of the purulent process to surrounding tissues can occur as a phlegmonous inflammation with necrosis of the bursa wall and the formation of subcutaneous and intermuscular phlegmon. In advanced cases, fistulas that do not heal for a long time are formed. The breakthrough of pus into the joint cavity leads to the development of purulent arthritis.
In acute traumatic bursitis, hemorrhagic fluid (blood or plasma) accumulates in the stretched synovial bursae and their pockets. With reverse development, fibrin is organized and the vessels of the synovial membrane are obliterated. Persistent changes develop in the wall of the bursa, which thickens, the surface of the synovial membrane is covered with growths of connective tissue (proliferative bursitis), dividing the cavity of the bursa into additional pockets.
When acute inflammation subsides and in the subacute course of bursitis, encapsulated areas of necrotic tissue or exudate remain in the wall and pockets of the bursae, which, with repeated injury and infection, serve as fertile ground for the development of recurrent inflammation (recurrent bursitis).
At the site of the anatomical location of the bursa, a round, limited, painful swelling of a soft-elastic consistency, fluctuating, is determined. The diameter of the swelling can reach 8-10 cm (Fig. 1). The patient complains of pain in the area of swelling, malaise; body temperature rises; joint function is moderately limited.
With phlegmonous inflammation, there is swelling of the tissues surrounding the bursa, hyperemia of the skin (lymphangitis), and general symptoms of the disease are pronounced (especially with gonorrheal bursitis): severe pain, fever up to 39-40°. As inflammation progresses and spreads to soft tissue, signs of phlegmon are determined.
In chronic bursitis, at the location of the bursa there is a rounded, limited swelling of soft consistency, the skin over it is mobile, not changed, and the function of the limb is not impaired. The chronic process may worsen; this increases the amount of fluid in the cavity of the bag, which sometimes leads to the formation of an isolated cystic cavity filled with fluid, called a hygroma.
Features of bursitis of different localization
In the area of the shoulder joint, the most commonly affected bursae are those that do not communicate with the joint cavity, the subcutaneous acromial, subdeltoid and subacromial (Fig. 2). Complaints boil down to pain during abduction and rotation of the upper limb. Bursitis of the subdeltoid bursa is especially painful.
Area of the left shoulder joint, rear view (Fig. 2):
Upon examination, the contours of the shoulder are smoothed, and there is an apparent uniform increase in the deltoid muscle itself; with large bags, swelling is visible on the outer surface of the shoulder. Palpation usually reveals pain when pressing on the inner edge of the greater tuberosity of the humerus. Supraclavicular bursitis often has to be differentiated from purulent arthritis, as well as from a very common disease of the shoulder joint - glenohumeral periarthritis.
Acute bursitis of the ulnar bursa is most often the result of mechanical damage and infection of the subcutaneous ulnar bursa due to injury. The bag increases sharply in size and takes on a hemispherical shape. The addition of infection is accompanied by the appearance of severe pain, redness of the skin in the area of the olecranon, and increased temperature. Acute bursitis often affects the radiohumeral bursa, located between the tuberosity of the radius and the biceps tendon (Fig. 3) (tennis players' bursitis).
The area of the right elbow joint, rear view (a) and front view (b) (Fig. 3):
Bursitis in the hip joint varies in severity; inflammation often spreads to the hip joint. More often, the deep-lying iliopectinal bursa, located between the muscles and the joint capsule, as well as the superficial and deep bursa of the greater trochanter are subject to inflammation. With purulent inflammation of these bags, sharp pain is noted when abducting the limb, extending and rotating the hip. The hip is in flexion, abducted and slightly externally rotated. Upon palpation, a painful, elastic swelling is determined along the anteromedial surface of the thigh under the inguinal ligament. With purulent inflammation of the greater trochanteric bursa, the swelling is often located on the outer surface of the thigh. Based on the severity of the clinical course and the similarity of symptoms, these types of bursitis are in some cases difficult to distinguish from purulent inflammation of the hip joint. With bursitis, in contrast to arthritis, the following are observed: 1) relative painlessness of flexion and adduction of the hip; 2) absence of pain when loading the limb along its length; 3) the presence of a swelling located on the anterior inner side of the thigh below the inguinal ligament. To distinguish the lesion of the subcutaneous bursa of the greater trochanter from the lesion of the deep bursa allows the displacement of the latter during posterior movements of the hip; with inflammation of the subcutaneous trochanteric bursa, no displacement is noted.
In the area of the knee joint, the prepatellar bursae are most often affected - subcutaneous, subfascial and subtendinous (Fig. 4); they do not communicate with the knee joint. Due to its more superficial location, the subcutaneous bursa is most often affected. Inflammation is accompanied by severe local edema, fluctuation, increased temperature, and enlarged regional lymph nodes. Inflammation of the deep infrapatellar bursa often occurs secondarily as a complication of acute gonitis. Popliteal bursitis is difficult to diagnose due to the deep location of the bursa; with it there is some restriction of movement and pain in the knee joint.
The area of the right knee joint, front view (a) and longitudinal section (b) (Fig. 4):
A common type of bursitis in the foot area is inflammation of a large bursa located between the heel tubercle and the heel tendon - Achilles bursitis. It is caused by trauma to the synovial bursa with shoes, hematogenous or lymphogenous infection. Bursitis of the subcutaneous heel bursa is a painful swelling in the area of the heel tubercle. The inflammatory process may be limited to the serous impregnation phase or lead to abscess formation. In some cases, this type of bursitis must be differentiated from inflammation caused by injury to the soft tissues of the heel “spur.”
The diagnosis is simple for inflammation of superficially located bursae and is based on the typical clinical signs described above. The diagnosis is facilitated by puncture of the bursa cavity, which makes it possible to determine from the resulting contents the nature of the inflammation (serous, purulent, purulent-hemorrhagic, etc.), to determine the nature of the microbial flora and its sensitivity to antibiotics.
To carry out the most effective treatment, it is important to exclude the specificity of the infection that caused the inflammation (gonococci, brucella, spirochetes, etc.), which is possible on the basis of a carefully collected anamnesis, bacteriological examination of the contents of the bags, and the results of specific serological reactions. The main differential diagnostic feature to distinguish bursitis from arthritis is the preservation of movement in the joint. X-ray diagnosis of superficial (subcutaneous) bursitis of any location is relatively simple. Due to their availability for clinical recognition, it is usually only of a clarifying nature. X-ray diagnostics of deep bursitis is of much greater practical importance. Among them, the radiologist most often encounters bursitis of the knee joint and greater trochanter of the femur, achillobursitis and inflammation of the unstable subacromial mucous bursa, and on the upper limb - with chronic subacromial bursitis.
For acute bursitis in the early stages, rest, a pressure bandage, and warm compresses are recommended. To prevent purulent bursitis, early active treatment of the serous form of acute bursitis and the use of fixing bandages is necessary.
In case of chronic bursitis, they often resort to puncture with removal of exudate and subsequent washing of the bursa cavity with solutions of antiseptics or antibiotics. For traumatic bursitis, a hydrocortisone solution is injected into the cavity of the synovial bursa (25-50 mg with antibiotics 2 to 5 times after preliminary administration of 8-10 ml of a 2% novocaine solution). Careful adherence to asepsis is important, as otherwise serious complications are possible. For purulent bursitis, puncture treatment is used. If the process progresses, they resort to opening the bag and removing the pus; a purulent wound is treated according to general rules. The disadvantage of this method is the duration of healing of the surgical wound.
The prognosis for acute bursitis depends on the degree of pathological changes in the tissues of the affected bursae, their prevalence, the ability of the infection to spread, and the patient’s body’s resistance. Unfavorable outcomes of acute bursitis can occur when it is complicated by arthritis, osteomyelitis, fistulas, and sepsis. Relapse in chronic traumatic bursitis is observed in 2-2.5% of those operated on.
Prevention consists of eliminating permanent trauma to the synovial bursae, in particular wearing protective bandages, careful primary treatment of wounds of the synovial bursae with antiseptics (treatment with hydrogen peroxide, application of a bactericidal patch/bandage), timely and rational treatment of pustular diseases.
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