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PubMed2004

Greater trochanter bursitis pain syndrome in females with chronic low back pain and sciatica.

Trochanteric bursitis is a clinical condition which simulates major hip diseases and low back pain, it may also mimic nerve root pressure syndrome. Patients with greater trochanteric bursitis pain syndrome (GTBPS) usually suffer from pain radiating to the posterolateral aspect of the thigh, paraesthesiae in the legs, and tenderness over the iliotibial tract.. The purpose of this study is to indicate the similarity between the clinical features of the GTBPS and those of chronic low back pain, and to highlight the importance of diagnosing GTBPS in patients complaining of low back conditions. Three hundred female patients were included in this prospective study. All patients complained about chronic low back pain or sciatica and had a failed long term conservative treatment. Local injection of the tender peritrochanteric area was only done in half of the patients (group 1). Patients were required to answer the Oswestry Disability Index Questionnaire during all periods of follow-up. Patients of group 1 had a better clinical outcome (p < 0.0005) than the patients in group 2 where no injection was done. We conclude that greater trochanter bursitis pain syndrome is a frequent syndrome which may be associated with low back symptoms. Patients with a long standing history of low back pain and sciatica should be routinely checked for GTBPS. GTBPS is easy to diagnose and can be treated. Peritrochanteric infiltration with glucocorticoids mixed with 2% lidocaine relieves patients from their symptoms for a long period of time. Recurrence should always be expected, but treatment may be repeated.

Activities of Daily Living↗

PubMed2006

Hamular Bursitis and its possible craniofacial referred symptomatology: two case reports.

The diagnosis of craniofacial pain is conditioned by the interdisciplinary management of its presentation especially in the absence of unique and objective signs. Bursitis is a pathological entity recently found in the hamular area and should be included in the diagnosis for exclusion of temporomandibular disorders (TMD), ear-nose-throat pathologies, due to the similar symptomatology to other head and neck conditions. The hamular process bursitis is a painful condition that can easily be confused with glosopharinge or trigeminal neuralgia that generates an uncomfortable feeling in the oropharinge with ipsilateral referred--heteretopic-symptomatology to the head. This pathology, in chronic states, can be responsible for the amplification of the pain perceived by the central excitation effect. In this report are presented two clinical cases of hamular bursitis and its conservative therapeutic management. The recognition of the inflammation of the bursa of the tensor veli palati muscle supplies the specialist with another tool in the management of craniofacial pain.

Adult↗

PubMedDate not supplied

Septic bursitis of the foot: diagnosis, management and end-result.

Septic bursitis of the foot is a disorder infrequently reported in the medical literature. This infrequent reporting may represent a true low incidence of occurrence or may be a reflection of failure to recognize and diagnose this condition. This paper retrospectively reviews the presentation, clinical course, and outcome of patients presenting with septic bursitis of the foot. The authors have reviewed those features of this disorder that may aid the clinician in diagnosis and management of this infrequent, but disabling entity. They describe a brief case history of 10 patients with septic bursitis of the foot, provide radiographic and microbacterial evaluation, and give an outcome determination. They make recommendations for diagnosis and treatment based upon this review of patients and review of the literature.

Adult↗

PubMed1989

Treatment of nonseptic olecranon bursitis. A controlled, blinded prospective trial.

We enrolled 42 patients with nonseptic olecranon bursitis in a double-blind prospective treatment trial to compare the efficacy of an intrabursal steroid preparation with that of an oral anti-inflammatory agent. Patients were randomized into one of four treatment regimens: (1) methylprednisolone acetate (20 mg) intrabursal injection and oral naproxen (1 g/d for 10 days), (2) methylprednisolone acetate (20 mg) intrabursal injection and oral placebo for 10 days, (3) oral naproxen (1 g/d for 10 days), and (4) oral placebo for 10 days. The degree of swelling in millimeters was assessed at study introduction and at 1, 3, and 6 weeks. At 6 months, the number of patients requiring reaspiration for bursitis recurrence was tabulated. Data at 1 week indicated that patients treated with an intrabursal methylprednisolone acetate injection (20 mg) demonstrated the most rapid decrease in swelling. At 6 weeks, the methylprednisolone-treated groups demonstrated sustained improvement. At 6 months, the mean number of reaspirations per patient for reaccumulation of bursal fluid was higher in groups 3 (1.0 +/- 1.2) and 4 (0.4 +/- 0.7). An intrabursal methylprednisolone acetate 20-mg injection seems to be the most effective treatment regimen for nonseptic olecranon bursitis.

Administration, Oral↗

PubMed1989

Septic bursitis in human immunodeficiency virus infection.

Septic bursitis is a well described entity in immunocompromised patients. Common factors contributing to an immunocompromised state are alcoholism and corticosteroid therapy. We describe 2 patients with Staphylococcus aureus olecranon bursitis with evidence of human immunodeficiency virus (HIV) infection and no other contributing factors to immunodeficiency. The clinical course in these patients was refractory to conservative management. Such a persistent course of septic bursitis, especially in the absence of other contributing factors, should raise the possibility of HIV infection.

Acquired Immunodeficiency Syndrome↗

PubMed1986

Treatment of septic olecranon and prepatellar bursitis with percutaneous placement of a suction-irrigation system. A report of 12 cases.

Ten cases of septic olecranon bursitis and two cases of septic prepatellar bursitis were treated in the period from 1975 to 1980 with antibiotics and percutaneous tube placement for suction-drainage and local antibiotic irrigation. All patients had positive bacterial cultures: Staphylococcus aureus in nine, beta-hemolytic Streptococcus in two, and Staphylococcus epidermidis in one. Intravenous antibiotics, local suction-drainage, and irrigation with a solution of 1% kanamycin and 0.1% polymyxin controlled the infection in each case. The antibiotic treatment averaged 19 days, compared with 24 days in a series in which suction-irrigation was not used. In contrast with studies in which aspiration or incision and drainage were performed, there were no complications or recurrences. Percutaneous suction-irrigation appears to be a safe, effective method of treatment that is particularly beneficial in severe cases of septic bursitis in which continuous drainage is desirable.

Adult↗

PubMed1987

[Bursitis calcarea in a dog].

A case of bursitis calcarea in a Border Collie showing lameness without acute pain in the right hind leg, is reported. A diagnosis of bursitis calcarea was made on radiological examination. Treatment consisted of anti-inflammatory drugs and rest as far as it was practically possible. After initial improvement, full recovery only took place 2 months after treatment had commenced. Bursitis calcarea is a rare disease which seldom shows clinical signs. As far as could be ascertained, this is the first report of the condition in South Africa.

Animals↗

PubMed1986

Trochanteric bursitis: a common clinical problem.

In 72 patients followed for two years, the diagnosis of trochanteric bursitis was based on precise clinical signs without significant contribution from laboratory tests or radiologic signs. In six of the patients (8.3%) the bursitis was an isolated condition of unknown origin. Six other patients had rheumatoid arthritis without involvement of the ipsilateral hip joint. The remaining 60 patients (83.4%) had pathologic conditions of the adjacent areas, such as symptomatic lumbar spine arthrosis or ipsilateral hip damage, conditions that often mask the actual source of pain and disability. A rapid and prolonged improvement of the pain and disability caused by the bursitis was achieved in all 65 patients (90.3%) treated by local corticosteroid and anesthetic infiltrations: in 48 patients after one, in 13 after two and in 4 after three local treatments. Local corticosteroid infiltration proved to be the treatment of choice as well as a diagnostic test.

Adult↗

PubMed1983

Hemophilus influenzae bursitis and meningitis in an adult.

Septic bursitis caused by Hemophilus influenzae, to our knowledge, has not been described previously. We treated a patient who had bursitis and meningitis caused by a nontype B Hemophilus influenzae. The clinical features of septic bursitis are briefly discussed and the importance of bursal aspiration and culture is emphasized.

Bursitis↗

PubMed1983

Prepatellar bursitis due to anaerobic Streptococcus.

A previously healthy 65-yr-old man developed clinical signs of prepatellar bursitis. Aerobic cultures from fluid aspirated from the inflamed prepatellar bursa were negative. Direct microscopic examination of the fluid showed gram-positive cocci, and anaerobic cultures grew Streptococcus hemalyticus group A. The bacterial etiology of bursitis has recently been emphasized in the literature; in most of our cases Staphylococcus was responsible. Negative cultures were next in frequency. Other microorganisms may indeed be responsible for prepatellar bursitis and should be sought where aerobic cultures are negative.

Aged↗

PubMed1994

Conservative treatment of calcific trochanteric bursitis.

OBJECTIVE: To present a case of conservatively managed calcific trochanteric bursitis and discuss differential diagnosis and treatment alternatives. CLINICAL FEATURES: A 53-yr-old obese female presented with acute severe lateral hip and posterolateral thigh pain. Examination findings were consistent with trochanteric bursitis and radiographs demonstrated calcific infiltration of the trochanteric bursa. INTERVENTION AND OUTCOME: An intensive 2-wk course of pulsed ultrasound, ice massage, interferential current and chiropractic lumbopelvic manipulation resulted in symptomatic relief, abolishment of palpatory tenderness and return of pain-free passive and resisted range of motion of the hip. CONCLUSIONS: Trochanteric bursitis is a common cause of hip pain. A trial of conservative measures is warranted for this condition, even when calcinosis is present, before more invasive therapies are considered.

Bursitis↗

PubMed1996

Evaluation of glucocorticosteroid injection for the treatment of trochanteric bursitis.

OBJECTIVE: We conducted an open observational study to assess the short and longterm effect of single local glucocorticosteroid injection for trochanteric bursitis. METHODS: 75 patient diagnosed with trochanteric bursitis based on clinical criteria were injected; 20, 32, and 22 patients each received 6, 12, and 24 mg betamethasone, respectively, mixed with 4 cm3 of 1% lidocaine. A standardized baseline questionnaire was administered to assess the severity and functional limitation due to trochanteric pain, including the visual analog scale for pain. Patients were followed at Weeks 1, 6, and 26 to determine their response to treatment. RESULTS: 77.1, 68.8, 61.3% of responding patients reported improvement in pain at Week 1, 6, and 26, respectively. Patients receiving higher doses of betamethasone were more likely to experience pain relief (p < 0.0123). CONCLUSION: Corticosteroid and lidocaine injection for trochanteric bursitis is an effective therapy with prolonged benefit.

Aged↗

PubMed1995

Bursitis of the iliopsoas: four cases with pain as the only clinical indicator.

Bursitis of the iliopsoas is a clinical entity rarely encountered, and may be underdiagnosed. Reports in the literature have usually considered the condition to result from an increase in bursal volume. Bursitis of the iliopsoas is most commonly observed in conjunction with pathologies such as rheumatoid arthritis or osteoarthritis of the hip, and is rarely reported as an isolated condition. We describe 4 cases of bursitis of the iliopsoas in which bursal swelling was absent and hip pain was the only clinical indicator. Diagnostic and therapeutic criteria based on clinical and radiological criteria are suggested.

Adult↗

PubMed1998

Olecranon bursitis caused by infection with Candida lusitaniae.

We describe a 59-year-old woman with diabetes and chronic asthma treated with prednisone and methotrexate who developed chronic olecranon bursitis caused by Candida lusitaniae. Infection, especially with unusual microbial pathogens, should be considered in cases of chronic bursitis in patients taking immunosuppressive medicine, even if the classic signs of septic bursitis are absent. Infection with C. lusitaniae, a component of the normal mycoflora, may be a marker of serious immunosuppression, as this patient ultimately died of a Pneumocystis carinii infection.

Asthma↗

PubMed1997

[Olecranon and pre-patellar bursitis].

Olecranon and prepatellar bursitis have a prevalence of 3 in 1000 patients; the predominant etiology is a traumatic lesion with or without inoculation of infectious material, mainly during professional or leisure activities. Separation into septic and non-septic bursitis is possible in most cases according to clinical parameters and characteristics of the contents of the affected bursa. The therapy of acute and chronic bursitis is guided mainly by the nature of the aspirate retrieved from the bursa: a serous content justifies conservative treatment with compression, immobilization, antiphlogistic medication, and (in selected cases) the instillation of corticosteroids; a purulent aspirate necessitates bursotomy with incision and drainage, or bursectomy. Only in selected cases is a conservative trial with antibiotics, immobilization, and antiphlogistic medications justified.

Bursitis↗

PubMed1998

Retrocalcaneal bursitis in spondyloarthropathy: assessment by ultrasonography and magnetic resonance imaging.

OBJECTIVE: To establish by magnetic resonance imaging (MRI) and ultrasonography (US) the frequency of retrocalcaneal bursa involvement in Achilles enthesitis of spondyloarthropathy (SpA) and to compare the results of the 2 examinations. METHODS: Nineteen Achilles tendons with severe enthesitis and 9 normal tendons of 14 patients meeting the Amor criteria for SpA were examined by MRI and US. RESULTS: Both MRI and US showed a significant increase in the mean Achilles tendon thickness in the pathologic legs compared to the normal legs both at the superior calcaneal surface and 3 cm above. MRI showed retrocalcaneal bursitis in 14 (73.7%) of 19 pathologic legs and superficial bursitis in 2 (10.5%). US showed fluid collection only in 7 of 14 retrocalcaneal bursae positive on MRI, and failed to show fluid in the 2 superficial bursae involved. Using MRI as the gold standard, US showed 50% sensitivity and 100% specificity for retrocalcaneal bursa involvement and lacked sensitivity for superficial bursitis. CONCLUSION: Achilles tendon involvement in SpA is not only a disease of the enthesis but also of the adjacent bursae.

Achilles Tendon↗

PubMed2004

Evidence-based soft tissue rheumatology: III: trochanteric bursitis.

Trochanteric bursitis is a term used to name a syndrome that features pain and tenderness over the greater trochanter. Present evidence suggests that in the majority of cases, symptoms result from pathology of the gluteus medius or minimus muscles rather than a bursa. Lower limb length discrepancy, iliotibial band contracture, hip osteoarthritis and lumbar spondylosis are often mentioned, but no proved as predisposing factors. After a lumbar spine or hip and other local pathology have been considered and clinically excluded, the clinical features of the syndrome, ie lateral location of pain plus characteristic trochanteric tenderness are usually sufficient to reach a diagnosis. Most patients with trochanteric bursitis can be successfully treated with a NSAID, physiotherapy plus a local corticosteroid injection. The few refractory cases are often treated surgically. Disappointingly, none of the therapeutic interventions used in trochanteric bursitis have been validly assessed.

Journal Article↗

PubMed1989

Septic and nonseptic olecranon bursitis. Utility of the surface temperature probe in the early differentiation of septic and nonseptic cases.

Forty-six consecutive cases of olecranon bursitis were prospectively analyzed during a 1-year period. Eleven cases were septic; 35 cases were nonseptic. In addition to bursal fluid analysis, the surface temperature over the involved olecranon bursa and the contralateral (control) olecranon process was obtained by using a surface temperature probe. We compared the temperature difference between the involved and control sides in all septic and nonseptic cases. In nonseptic cases, the mean surface temperature difference was 0.7 degree C vs 3.7 degrees C in septic cases. In all septic cases, the temperature difference was 2.2 degrees C or greater (range, 2.2 degrees C to 5.1 degrees C; SD, 1.1). Use of the surface probe temperature difference proved 100% sensitive and 94% specific in discriminating septic from nonseptic cases. It seems to be more helpful than the bursal fluid leukocyte count, the predominant cell type, or Gram's stain in the early differentiation of septic and nonseptic olecranon bursitis.

Adult↗