Inflammation of the bursa

INFLAMMATION OF THE BURSA

Diagnosis: INFLAMMATION OF THE BURSA
(Bursitis)


Anatomy:
On the upper arm there are numerous bursas, reducing the pressure on muscles and tendons, where these lie close to the bone.

  1. M. biceps brachii
  2. Epikondylus mediale
  3. Aponeurosis m. bicipitis brachii
  4. M. pronator teres
  5. M. flexor carpi radialis
  6. M. palmaris longus
  7. M. flexor digitorum superficialis
  8. M. flexor carpi ulnaris

FLEXORS OF THE FOREARM

Cause: In case of repeated loads or blows the bursas can become inflamed, produce fluid, swell and become painful. Even though the condition is called bursitis the bursa is usually not infected. One of the most frequent bursitis forms, on the upper arm, is inflammation of the bursa located between the biceps tendon and the fastening on the radius (tuberositas radii).

Symptoms: Pain upon applying pressure on the bursa, which sometimes (but far from always) may feel swollen. Aggravated upon activation of the muscle located immediately above the bursa.

Acute treatment: Click here.

Examination: In light cases with only minimal tenderness, medical examination is not necessarily required. In cases of more pronounced pain or lack of progress, a medical examination should be carried out to ensure a correct diagnosis and treatment. A normal medical examination is usually sufficient in order to make the diagnosis, however, if there is any doubt concerning the diagnosis an ultrasound scan can be performed.

Treatment: The treatment primarily consists of relief. Removal of the provoking cause, if such is known. The treatment can be supplemented with rheumatic medicine (NSAID) or the injection of corticosteroid in the bursa preceded by draining of the bursa, which can advantageously be done under ultrasound guidance.

Rehabilitation: The treatment is completely dependant on which bursa is inflamed, but sports activity can usually be cautiously resumed once pain has decreased, particularly if it has been possible to remove the provoking cause.

Complications: If smooth progress is not achieved, it should be considered whether the diagnosis is correct or whether complications have arisen. In rare cases the bursa can become infected with bacteria. This is a serious condition where the bursa becomes red, warm and increasingly swollen and tender. This condition requires immediate medical examination and treatment. 
If there is no progress with relief, medical treatment rheumatic medicine (NSAID) and the ultrasound guided injection of corticosteroid, surgical removal of the bursa may be attempted.