What is it about ?
A serous bursa is a small, fluid-filled pocket that is found in places where muscle tendons pass right next to very hard structures like bones. The bursa protects these tendons from abnormal friction which could damage them. Most often, these bursaries are found near large joints, such as the hip, knee, elbow, and shoulder.
There are two types of scholarships: the superficial and the deep. Deep bursae are already present at birth, superficial ones only appear afterwards. In total, a human being has an average of 156 bursae, distributed all over the body.
An inflammatory reaction can occur in case of sudden excessive pressure (due to trauma) or prolonged pressure (by the profession practiced or the sport practiced). In this case, you have a so-called “aseptic” bursitis because it is not caused by a germ. It can be acute or chronic. This condition most commonly occurs in the knee and elbow.
- Elbow bursitis usually develops after sudden shocks or after prolonged pressure in a certain position (students).
- Knee bursitis is caused by trauma (fall or direct shock) or by prolonged irritation such as kneeling while sitting on the heels.
A bursa can also be contaminated with bacteria from an injury or infection in the area. In this case, it is called septic bursitis.
Sometimes there is no single cause to explain the presence of bursitis. We then qualify it as “primary”. In rare cases, rheumatism or gout is the cause of bursitis.
In whom and how often does it occur?
Bursitis is often classified as “knee disorders” or “elbow injuries”, so there are no specific figures for the number of cases. We know that the frequency increases with age and that they occur more in men than in women. The number of cases has increased in recent years.
How to recognize it?
The main features are inflammation and functional limitation:
- Inflammation can be recognized by 4 signs: redness, local heat, pain and swelling.
- Functional limitation means that certain movements, such as bending or straightening the knee or the elbow, become more difficult, if not impossible.
An elbow bursitis looks like a pocket hanging from the tip of the elbow. Knee bursitis causes swelling, usually just above or below the kneecap.
How is the diagnosis made?
The symptoms felt and the appearance generally leave little doubt. The diagnosis is therefore relatively simple. The doctor will always try to distinguish between infected (septic) and uninfected (aseptic) bursitis. To do this, a puncture of the fluid in the bursa is necessary.
In traumatic (acute) bursitis, the bursa contains mostly blood. If infected, pus will also be present in addition to the blood. With chronic inflammation, rheumatism or gout, the puncture shows a rather clear yellowish liquid. Everything is analyzed in more detail in the laboratory.
What can you do ?
Avoid prolonged pressure on the elbows and knees.
If, by your profession, you often have to kneel (tiler), use knee pads. This precaution also applies to the practice of sports with a high risk of falling, such as rollerblading, skateboarding or volleyball.
An inflamed joint feels hot when touched. It is therefore important to cool the area by applying ice. If the redness and swelling increase rapidly or if you have a mild fever, there is a risk of infection. See your doctor as soon as possible.
What can your doctor do?
The puncture of the affected bursa is useful not only for making a correct diagnosis, but also partly for treatment. It makes it possible to reduce the pressure in the bursa and therefore to reduce the pain.
In chronic bursitis, the fluid is withdrawn from the bursa and injected with a corticosteroid. This procedure is repeated, if necessary, after 2-4 weeks.
If the inflammation persists and becomes bothersome, the bursa can be removed surgically.
In case of (suspected) septic bursitis, antibiotics are immediately started at high doses. Hospitalization may be necessary to administer antibiotics by infusion.
Finally, in case of rheumatism or drop, you will most often be referred to a rheumatologist for appropriate treatment.