Bursitis natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
Overview
Bursitis is often caused by recurrent micro-trauma and overuse. Symptoms of bursitis may develop rapidly within 2 to 3 days in an acute form. Patients with bursitis usually present with edema, erythema, and tenderness over the involved joint. In most cases after adjustment of activities, bursitis will gradually clear within a few days to weeks without any long-term consequences. If left untreated, acute bursitis may lead to chronic bursitis, which can result in cicatricial adhesions, reduced mobility, and progressive pain. With treatment and an adjustment in activities, septic and aseptic bursitis are associated with excellent prognoses.[1][2][3][4]
Natural History
Aseptic bursitis is often caused by recurrent micro-trauma and overuse. Symptoms of bursitis may develop rapidly within 2 to 3 days in an acute form. It usually presents with edema, erythema, tenderness, and stiffness over the involved joint. In most cases, after an adjustment of activities, bursitis will gradually clear within a few days to weeks without any long-term consequences. If left untreated, acute bursitis may lead to chronic bursitis, which can result in cicatricial adhesions, reduced mobility, and progressive pain.[5][6]
Septic bursitis often occurs in patients with underlying medical conditions such as diabetes, immunosuppression, and alcoholism. Symptoms of septic bursitis develop rapidly after bursal infection with a bacterial organism that has entered a patient's system through a skin breakdown or cut. Patients may present with fever, warmth, erythema, edema, and pain over the joint. If left untreated, septic bursitis may lead to osteomyelitis or cutaneous fistula formation. Additionally, bursitis may lead to recurrent infection in immunocompromised patients.[7]
Complication
Common complications of bursitis include:[4][7]
- Cicatricial adhesions in the joint
- Reduced range of motion or mobility
- Progressive pain
- Limited activity level
Prognosis
- With treatment and an appropriate adjustment in activities, aseptic bursitis is associated with an excellent prognosis.
- With appropriate antibiotic treatment, septic bursitis is associated with a good prognosis. In rare cases, the infected bursa may have to be removed surgically if other treatments are ineffective.[4]
References
- ↑ Fauci, Anthony S., and Carol Langford. Harrison's rheumatology. McGraw Hill Professional, 2010.
- ↑ Walker‐Bone, Karen, et al. "Prevalence and impact of musculoskeletal disorders of the upper limb in the general population.
- ↑ Aaron, Daniel L., et al. "Four common types of bursitis: diagnosis and management." Journal of the American Academy of Orthopaedic Surgeons 19.6 (2011): 359-367.
- ↑ 4.0 4.1 4.2 Raddatz DA, Hoffman GS, Franck WA (1987). "Septic bursitis: presentation, treatment and prognosis". J Rheumatol. 14 (6): 1160–3. PMID 3437425.
- ↑ Fauci, Anthony S., and Carol Langford. Harrison's rheumatology. McGraw Hill Professional, 2010.
- ↑ Walker‐Bone, Karen, et al. "Prevalence and impact of musculoskeletal disorders of the upper limb in the general population.
- ↑ 7.0 7.1 Ho G, Tice AD, Kaplan SR (1978). "Septic bursitis in the prepatellar and olecranon bursae: an analysis of 25 cases". Ann Intern Med. 89 (1): 21–7. PMID 666181.