Causes, symptoms and complications of bursitis

There are other reasons:

• overstressing of the joint, arising from its "curvature" (for example hallux valgus, flat feet), damage or at weight lifting, wearing too narrow shoes and high heels, in excess weight;

• various diseases accompanied by inflammation, e.g., arthritis (gout , and scleroderma), boils a carbuncle, erysipelas, osteomyelitis, SARS, flu, sore throat, brucellosis, drives, bronchitis, sinusitis, otitis, abscess;

• violation of metabolism, for example, when the sores;
• calcined tendons and the surrounding areas;
• injuries to the Bursa, the patella or the surrounding tendons;
• damage to or pathological changes of the skin in the region of the joint, leading to penetration of infection into the Bursa. This can happen by careless cutting of calluses and corns;
• an Allergy causes an overabundance of antibodies. In the acute phase of the immune response basophils secrete a variety of mediators of inflammation;
• poisoning (toxins into the blood, poison the tissues);

• autoimmune diseases. The immune system produces antibodies against healthy tissue.

Excessive load on the joints is very common. They are typical, for women who love to walk in high heels, men dragging heavy all full of people. If bursitis develops as a complication of another disease, treatment is complex. Arthritis inflammation of periarticular bag spread out of the joint, osteomyelitis from bone marrow.

Any inflammation takes place in 3 stages:

1. Alteration – damage to cells (including pathogens);

2. Exudation – the release of liquid;

3. Proliferation – the restoration of integrity.

The second stage is fraught with 'contamination' of other bodies. The agents of the inflammatory process quickly spread throughout the body with blood.

Symptoms of bursitis

The main symptom of bursitis is swelling in the area injuredarea of the body.

Symptoms of bursitis include the definition of restricted patient rounded swelling, elastic consistency, fluctuating, on the site of the anatomic position of the bag. This swelling can have a diameter of about eight or ten inches.

There are such symptoms of bursitis:

• accumulation in the Bursa of excess fluid – exudate
• pain syndrome – aching, shooting, strong, throbbing pain radiating to the limb. They are worse at night. This happens because much less of the stimuli that can distract the patient. When people long to be in the stillness, swelling increases and the pain too.
• contracture of the joint. The limited movement appears due to pain, swelling and deposits of lime salts in the walls of the bag.

• edema– accumulation of fluid in the intercellular space as a result of hyperosmia

• redness of the skin – redness. Caused due to tension of the skin, its thinning, blood flow to the inflamed area.
• raising the local or General body temperature to 40
• General malaise, weakness
• nausea
• increase the surrounding lymph nodes

If the disease is phlegmatic, then the body temperature will range from thirty-nine to forty degrees. Bursitis occurs when swelling of certain skin tissues, thus the person will feel amplified pain, and body temperature will rise up to forty degrees.

Chronic bursitis is characterized by rounded reduced swelling of soft consistency, it occurs at the location of the bags. The skin over the swelling is movable, is not changed, the function of the limb is not broken.

Chronic bursitis can pass into the ganglion cyst, is related to the emergence of large amounts of fluid in the cavity of the swelling.

The types of bursitis

Experts use several grounds for classification of this disease. The nature of the disease distinguish acute and chronic bursitis. The acute form develops over a few days and chronic can occur with periodic exacerbations. These forms differ in the character of the pain.

The types of bursitis the causes:

• infectious or septic;
• aseptic, including traumatic.

Infection penetrates from the outside or from the inside:directly through broken skin, blood (hematogenous infection with pyogenic microbes) or lymph (lymphogenous). The nature of the pathogen distinguish nonspecific and specific bursitis.

The latter is caused by the following pathogens:

• the gonococcus;
• brutsellezom;

• staphylococci;

• streptococci;
• by Streptococcus pneumoniae;
• tuberculosis or Escherichia coli.
• The type of agent determines what will be the exudate, as will be leaking the disease.

The types of bursitis, depending on the lesion:

• shoulder;

• elbow;

• hip;

• knee:- (infrapatellar), knee (prepatellar) or Baker's cyst on the inner side of the ganglion cyst;

• ankle;
• calcaneal or Achilles bursitis;
• wrist.

Synovial bags located in various places. In accordance with their position differencesbut and types of bursitis:

• subcutaneous develops in the subcutaneous tissue on the convex surface of the joint;
• popasniany;
• podshadley;
• axillary.

Varieties of inflammation of the Bursa on the nature of the exudate:

• serous;
• purulent;
• hemorrhagic.

Type of disease usually caused by the type of infection you have, sport or profession. Bursitis resulting from overexertion of the legs after prolonged standing on her knees, called "water in knee", "roofer's knee", "knee parquet", "knee tiler"or"the knees of a maid/housewife". Also found in "the knee of the player", caused by frequent injuries. Occupational disease of the hands called "the watchmaker's elbow", "elbow jeweler/engraver," "miner's elbow", bursitis tennis players, etc. Still have "loader". The shape and the number of recurrences of bursitis depends on the profession and patient conditions.

Diagnosis of bursitis

Different types of bursitis are slightly different symptoms. The chronic form can be virtually asymptomatic. At different stages of the disease the swelling changing its size and density. Signs of bursitisappear in stages.

In the acute form in the morning the patient may find painful swelling. The skin in this place is red, hot to the touch, movable. With time to act limb will be harder. When the inflammation appears pus, will start a fever. If focal changes on the musculoskeletal apparatus is a complication of another disease, and its manifestations will progress.

Regional lymph nodes near the affected joint increased when the penetration of the products of inflammation. This is a reaction of the immune system. Can begin lymphadenitis. When shoulder bursitis enlarged lymph nodes in the neck and in the armpits, at the hips and knees – in the groin.

The reason for going to the clinic is usually pain and limited movements. Methods of diagnosis of bursitis:

• conversation;
• inspection;
• radiography;
• Ultrasound;
• computed tomography;
• magnetic resonance imaging;
• puncture with laboratory studies of recovered fluid;
• arthrography – endoscopy of the knee;
• General blood test to detect signs of inflammation;
• angiography of blood vessels to determine the extent of inflammation.

Diagnosis of certain types of bursitis is complicated by the fact that their symptoms similar to other inflammatory diseases. An example is arthritis - inflammation of the joint and synovitis is its shell. In addition, these pathologies can occur simultaneously. In this case, to identify the root cause quite difficult.

Depending on the test results, the orthopedist prescribes treatment. But most often, diagnosis is sufficient only visual methods and palpation.

To diagnose bursitis help simple tests:

1. The doctor asks the patient to try to have his hand behind his head while combing hair.

2. The patient should undergo a bit on his haunches.

If you find soreness and limited movement, then the probability of the disease increases. The farther from the surface of the body located inflamed bag, the harder it is for the technician to diagnose. But no matter how deep you hid the hearth, when pressure is applied the patient will feel pain.

Common symptoms of inflammation of the synovial bags differ little from the characteristics of other similar diseases. Nevertheless, it is important to be examined by a specialist in order to differentiate this disease and begin treatment.

Complications of bursitis

scar adhesions - seal, causing the immobility of the limb – contracture

calcification

infection of other organs, for example, tandoori and tendon rupture, abscess, osteomyelitis, subcutaneous and intermuscular cellulitis, arthritis, including purulent (when pus breaks through into the joint) and Coxeter

fistula – a fistula with pus formation

necrosis wall bag

sepsis

Adhesions sometimes occurs pathologically. Healing damaged by bursitis of the walls of the mucous bags of joints occurs abnormally, formed extra "threads" - spikes. They create an unwanted connection, preventing normal movements of the organs.

Unpleasant that such growths often occur unnoticed. To see them is not always possible even with the help of ultrasound. Over time, pain, adhesive disease progresses. If this process is provoked by hip bursitis, abnormal scarring can capture and reproductive organs of women, causing infertility.

The inflammation easily spreads from the joint capsule by the tendon. Their fibers are closely intertwined with the outer fibrous sheath of the Bursa. So the muscle can more effectively perform the motor function, to enhance the process of motion of the articular surfaces.

Purulent bursitis the most difficult. The suppuration extends to the surrounding soft tissue and bone. Melts the connective tissue cellulitis. It differs from abscess that has no clear boundaries. This adverse outcomes of necrosis. Sometimes there is a spontaneous opening of abscesses. Fistulas appear.

Fixation dressing can so increase the pressure inside the Bursa that pus gets into other tissues, blood. He in large volume contains proteolytic enzymes melting proteins. So necrotic destruction of cells starts in other parts of the body.

Lymphoid tissue is almost always involved in inflammatory processes. The immune system to respond to infection. During the next examination, the orthopedic surgeon palpated the lymph nodes to which lymph flows out of the affected area. Pain indicates progression of the pathological state.

Necrosis of the inner lining of the Bursa will result in the cessation of secretion of synovial fluid.

Synovial fluid performsvery important for healthy joint function:

• nourishes,
• moisturizes
• helps slide.

Complicated bursitis increases pain. All the parts of the joint, in addition to hyaline cartilage, well innervated. At the same time developing pathology increase the number of inflammatory foci. The amplification of the inflammatory process pressure on various nerve endings intensifies the pain.

If untreated, the patient may become disabled or die. Self-medication is dangerous and can lead to tragic consequences. According to the surgeon D. S. Tevs: "it is Better to overestimate the seriousness of your symptoms, rather than later, seek medical help."

Treatment of bursitis

Conservative treatment of acute bursitis

In acute bursitis is most important for the patient is calm and stillness. If the bursitis appeared on the joints of the shoulder or elbow, the joint should be fixed with a plaster splint. If a person feels severe pain, give him aspirin or any pain medication, sometimes the pain will go away by themselves. In some cases, in order to better exudate resorbed, uses heat or, put ointment Vishnevskogo.

Modern methods allow patients to undergo treatment on an outpatient basis. Mandatory rest, diet. Specific measures depend on the causes of the disease. Usually they include the suppression of inflammation with antibiotics intravenously, anesthesia, strengthening the immune system.

In addition to the medical treatment prescribed massage and physiotherapy:

• ultraviolet irradiation;
• extracorporeal shock wave therapy;
• inductotherapy;
• paraffin or ozokerite applications;
• electrophoresis with various drugs.

Physiotherapy needs to increase metabolic process to prevent stagnation. They help to relieve swelling, reduce muscle tension in the affected area. Highly resolving action physiotherapy. Specific procedures are prescribed depending on the stage of the disease and condition of the patient.

The movement of the affected limb to restrict elastic bandages and special locking: brace, splint, etc. massage the bag of ice through the clothes. These measures help to reduce the pain. The diseased joint lifts, in order to prevent the development of edema.

After removing the inflammation exercise may increase gradually. The leg or armdevelop with the help of special exercises. Complex physical therapy is selected individually. Under favorable course of the disease, fails to suppress it for a week, otherwise 3 months. After the treatment it is important not to forget about preventive measures.

Surgical treatment of chronic post-traumatic bursitis

In chronic bursitis and possibly surgery, because the patient will complain of calcium deposits – provided that they are quite large, creating long-term discomfort or hinder movement.

When calcium deposits are removed with a needle or by surgical intervention. Sometimes with complete immobility of the joint working him under anesthesia.

Bursa can be drained, cleaned, cut adhesions and calcium deposits, and treat the cavity with antiseptics. When purulent bursitis sometimes requires extirpation periarticular bags. Surgically remove only a part, e.g. the mucosa. Modern methods allow to minimize the recovery period. The favorable outcome is operated can go home after a couple of hours. The last resort – bursectomy – complete removal of the Bursa. Special surgery – osteotomy, is accompanied by the movement of the bones and their fixation in the correct position with special metal rods.

In the media there are guidelines for conducting aspiration of fluid at home. To do so is extremely dangerous! This procedure is performed only by a specialist in sterile conditions. "Well-wishers", giving such advice, forget the speed with which can spread disease-causing microbes. Sepsis causes death in a few days.

Prevention of bursitis

disinfection scratches, abrasions, small wounds, abrasions antiseptics;

timely suppression of inflammation;

the avoidance of congestion;

correction of deformed joints;

diet.

sports is tailored to the individual health index.

Immediately treating wounds disinfecting compositions, it is possible to significantly reduce the risk of infectious diseases. If there is inflammation, there is a strong likelihood that it will spread with the lymph and blood. Timely suppressing the disease, you can avoid many complications.

People who are prescribed the wearing of special shoes, specialinsoles or tabs, it is impossible to neglect recommendations of experts.

There are following kinds of orthopedic products for different types of activities:

• orthoses for adjustable fixation of the hip and knee joints;
• bandage and sports orthosis for the knee joint and a Cup;
• compression and protivovirusny knit devices to facilitate its inserting;
• the hip brace;
• bandage for fixation of the Achilles tendon;
• bandage and sporting a brace on the ankle;
• outlet brace of the first toe of the foot for flexible hallux valgus;
• under - and napalechniki;
• the pelota, lined and the liner under the forefoot;
• the arch support;
• insoles and polustanka;
• interdigital insert;
• barcoprojection;
• interdigital corrector;
• metatarsal and the correcting substrate;
• interdigital septum and the insert;
• the protective cap and the ring on the toe;
• the bandage-clamping;
• the protective liner from corns;
• toe separator;
• elastic neckband and cuffs-tie forefoot;
• metatarsal pad;
• protector to protect the big toe joint and the little finger of the foot;
• cushion under the heel and toes;
• intimatley ring;
• protective socks;
• corrector and spacer between the toes of the foot;
• metatarsalgia roller;
• orthosis for big toe.

There are not only products useful for professional athletes, but also the means for correction of deformed joints. Orthopedic treatment is always complex and extended in time process. In severe cases, requires surgical intervention.

Those whose profession is connected with constant stress on the joints, you need to protect them. Put a soft pillow under the elbows or knees, wear a special protective bandage, take breaks with a little warm-up. Before heavy load be sure to "warm up"the joints with a special set of exercises. Before performing any exercises required to stretch: easy – moderate – hard. Recommended walking, Jogging, working with weights and swimming.

There are cases when discovering the swelling,the patient does nothing, continues to live on the principle of"self-will". The swelling's going down. But usually it is just an indicator of the beginning of the chronic stage of the disease. Ignoring the treatment, can cause spread of infection throughout the body.