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Bursitis, Emergency Medicine

Patrick H. Sweet Reviewed 06/2017
 


Basics

Description

  • Bursae are synovial fluid-filled sacs:

    • ∼150 are located between bones, ligaments, tendons, muscles, and skin.

  • They provide lubrication to reduce friction during movement.

  • Bursitis is in...

Diagnosis

Signs and Symptoms

History

  • Acute or chronic

  • History of trauma, overuse, or prolonged pressure

  • Pain with increased activity at respective joint or with pressure

  • Functional complaints (e.g., limpin...

Treatment

Pre-Hospital

May be difficult to distinguish from fractures; suspicious joints should be immobilized, particularly in the setting of trauma. 

Initial Stabilization/Therapy

  • Immobilize joint if p...

Follow-Up

Disposition

  • Most patients may be treated as outpatients.

  • Most patients respond to therapy in 3–4 days and may follow-up within 1 wk or PRN.

  • Septic bursitis requires repeated bursal aspiration e...

Pearls and Pitfalls

  • Exam alone may be unreliable in distinguishing between traumatic and septic bursitis:

    • Aspiration and fluid analysis may be the only method of distinguishing.

  • Beware of risk for GI he...

Additional Reading

  • DeLee  JC, Drez  D, Miller  MD, ed. DeLee & Drez's Orthopaedic Sports Medicine: Principles and Practice. 3rd ed. Philadelphia, PA: Saunders Elsevier; 2010:889–891, 1209–1212, ...

Codes

ICD9

  • 726.10 Disorders of bursae and tendons in shoulder region, unspecified

  • 726.33 Olecranon bursitis

  • 727.3 Other bursitis

  • 726.5 Enthesopathy of hip region

  • 726.65 Prepatellar bursitis

  • 726.79 Other ent...

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