Medical history (history of illness) represents an important component in the diagnosis of bursopathies (bursal disorders). Family history Are there frequent diseases of bones/joints in your family? Social history What is your profession? Current medical history/systemic history (somatic and psychological complaints). Are you experiencing pain? If yes, when does the pain occur? Where is the … Bursa Diseases (Bursopathies): Medical History
Endocrine, nutritional, and metabolic diseases (E00-E90). Hyperuricemia (elevation of uric acid levels in the blood). Hyperparathyroidism (hyperparathyroidism). Infectious and parasitic diseases (A00-B99). Hematogenous (in the bloodstream) spread of various infectious diseases such as gonorrhea, tuberculosis. Local infections such as boils Musculoskeletal system and connective tissue (M00-M99) Bursitis calcarea (calcified shoulder) – calcifications in the shoulder … Bursa Diseases (Bursopathies): Or something else? Differential Diagnosis
Other indications for surgical intervention in bursopathies include: Fluctuating purulent bursitis – in acute bursitis, relief incision only; definitive bursectomy (removal of the bursa) in the symptom-free interval. Chronic recurrent bursitis Baker’s cyst (cyst in the area of the popliteal fossa) – it should be removed only if there are symptoms; at the same time, … Bursa Diseases (Bursopathies): Surgical Therapy
To prevent bursopathies (bursal diseases), attention must be paid to reducing individual risk factors. Behavioral risk factors Chronic overuse
The following symptoms and complaints may indicate bursopathies (bursal disorders): Leading symptoms Pressure pain in the affected joint (pain; lat. dolor). Swelling of the affected joint (swelling; lat. tumor). Painful restriction of movement (functional restriction; lat. functio laesa). Fluctuation palpable
Pathogenesis (development of disease) A stimulus (inflammation, trauma) causes serous fluid to secrete into the bursa. If there is a chronic change in the bursa, wall thickening occurs, among other symptoms. Etiology (causes) Behavioral causes Chronic overwork Disease-related causes Endocrine, nutritional and metabolic diseases (E00-E90). Hyperparathyroidism (parathyroid hyperfunction). Hyperuricemia (elevation of uric acid levels in … Bursa Diseases (Bursopathies): Causes
The following are the most important diseases or complications that may be contributed to by bursopathies (bursal diseases): Musculoskeletal system and connective tissue (M00-M99). Chronic restriction of movement in the affected joint. Chronic pain in the affected joint
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin (normal: intact; abrasions/wounds, redness, hematomas (bruises), scars) and mucous membranes. Gait (fluid, limping). Body or joint posture (upright, bent, gentle posture). Malpositions (deformities, contractures, shortenings). Muscle atrophies (side … Bursa Diseases (Bursopathies): Examination
2nd order laboratory parameters – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification. Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Microbiological examination – if infectious diseases are suspected. Uric acid – if gout/hyperuricemia is suspected. Parathyroid hormone (PTH) – if hyperparathyroidism … Bursa Diseases (Bursopathies): Test and Diagnosis
Therapeutic target Relief of symptoms Avoidance of complications Therapy recommendations Analgesia (pain relief) for acute bursitis with according to WHO staging scheme. Non-opioid analgesic (paracetamol, first-line agent). Low-potency opioid analgesic (e.g., tramadol) + non-opioid analgesic. High-potency opioid analgesic (eg, morphine) + non-opioid analgesic. If necessary, anti-inflammatory drugs / drugs that inhibit inflammatory processes (non-steroidal anti-inflammatory … Bursa Diseases (Bursopathies): Drug Therapy
Optional medical device diagnostics – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification. Radiographs of the affected joint – to exclude bony involvement. Ultrasound diagnosis of the affected joint – to exclude joint effusion, capsular swelling, synovial villi (finger-shaped protrusions of the inner layer (membrana … Bursa Diseases (Bursopathies): Diagnostic Tests
General measures In acute bursitis, immobilization of the affected joint in the plaster splint or pressure bandage should be performed. At the same time, cooling compresses should be applied for several days. Conventional non-surgical therapy methods Bursitis: if necessary, puncture with corticosteroid instillation should be performed for nonbacterial infections. Baker’s cyst (popliteal cyst, popliteal cyst) … Bursa Diseases (Bursopathies): Therapy
