Diferencia entre revisiones de «Bursitis»

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(Expand with concise EM-focused content: types, clinical features, evaluation with aspiration criteria, management)
 
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*[[Septic Bursitis]]
==Background==
*[[Hip Bursitis]]
*Inflammation of a bursa (fluid-filled sac that reduces friction between tendons, bones, and skin)
**Trochanteric Bursitis
*May be traumatic, overuse (repetitive microtrauma), infectious ([[septic bursitis]]), or inflammatory ([[gout]], [[rheumatoid arthritis]])
**Iliopsoas Bursitis
*Olecranon and prepatellar bursae are most commonly affected in the ED
*[[Prepatellar Bursitis]]
 
*[[Pes Anserine Bursitis]]
==Types by Location==
*Shoulder: [[Subacromial bursitis]]
*Elbow: [[Olecranon bursitis]]
*Knee:
**[[Prepatellar bursitis (nonseptic)|Prepatellar bursitis]]
**[[Pes anserine bursitis]]
*[[Hip bursitis]]: Trochanteric, iliopsoas, ischial, iliopectineal
*Ankle: Retrocalcaneal bursitis
 
==Clinical Features==
*Localized swelling, warmth, tenderness over the affected bursa
*Pain with direct pressure or movement of adjacent joint
*May have limited range of motion
*'''Red flags for [[septic bursitis]]:''' fever, overlying cellulitis, significant erythema, history of penetrating trauma or immunocompromise
 
==Evaluation==
*Clinical diagnosis in most cases
*'''Aspiration''' (bursocentesis) if concern for [[septic bursitis]]:
**Cell count, Gram stain, culture, crystal analysis
**WBC >2,000/μL with >50% PMNs suggests infection (lower threshold than septic arthritis)
*X-ray to rule out fracture or foreign body if trauma history
 
==Management==
*'''Non-septic:''' Rest, ice, compression, NSAIDs, activity modification
*'''Septic:''' Antibiotics covering [[Staphylococcus aureus]] (most common organism), serial aspiration or surgical drainage
*Avoid corticosteroid injection until [[septic bursitis]] is ruled out
 
==Disposition==
*Discharge non-septic bursitis with RICE, NSAIDs, and PCP follow-up
*Septic bursitis: outpatient antibiotics if mild, admit if systemically ill or immunocompromised
 
==See Also==
*[[Septic bursitis]]
*[[Septic arthritis]]
 
==References==
<references/>
 
[[Category:Orthopedics]]
[[Category:ID]]
[[Category:Sports Medicine]]

Revisión actual - 01:18 21 mar 2026

Background

  • Inflammation of a bursa (fluid-filled sac that reduces friction between tendons, bones, and skin)
  • May be traumatic, overuse (repetitive microtrauma), infectious (septic bursitis), or inflammatory (gout, rheumatoid arthritis)
  • Olecranon and prepatellar bursae are most commonly affected in the ED

Types by Location

Clinical Features

  • Localized swelling, warmth, tenderness over the affected bursa
  • Pain with direct pressure or movement of adjacent joint
  • May have limited range of motion
  • Red flags for septic bursitis: fever, overlying cellulitis, significant erythema, history of penetrating trauma or immunocompromise

Evaluation

  • Clinical diagnosis in most cases
  • Aspiration (bursocentesis) if concern for septic bursitis:
    • Cell count, Gram stain, culture, crystal analysis
    • WBC >2,000/μL with >50% PMNs suggests infection (lower threshold than septic arthritis)
  • X-ray to rule out fracture or foreign body if trauma history

Management

  • Non-septic: Rest, ice, compression, NSAIDs, activity modification
  • Septic: Antibiotics covering Staphylococcus aureus (most common organism), serial aspiration or surgical drainage
  • Avoid corticosteroid injection until septic bursitis is ruled out

Disposition

  • Discharge non-septic bursitis with RICE, NSAIDs, and PCP follow-up
  • Septic bursitis: outpatient antibiotics if mild, admit if systemically ill or immunocompromised

See Also

References