Bursitis is defined as inflammation of bursa. A bursa is a sac that is formed or found in areas subject to friction, such as locations where tendons pass over bony landmarks. The most common sites are subdeltoid (upper arms), olecranon (elbows), prepatellar (knees), trochanteric (legs), and radiohumeral (lower arms). They essentially lubricate the region with synovial fluid. Large bursae usually communicate with joints and are responsible for retaining the synovial fluid in place. Bursae are fluid-filled sacs that serve as a cushion between tendons and bones. Bywaters, an English rheumatologist, found at least 78 bursae symmetrically placed on each side of the body.
Bursitis may be acute or chronic, and its etiology is often unknown. There are many types of bursitis, including infectious, traumatic, inflammatory or gouty. Less often rheumatoid disease or tuberculosis as well as gout and pseudogout.
Individuals who engage in repetitive and vigorous training or others who suddenly increase their level of activity (e.g., "weekend warriors") are at higher risk of developing bursitis. Also, improper or over-zealous stretching may lead to injury.
Standard lab testing aids in differentiating soft tissue disease from rheumatic and connective tissue disease: CBC; ESR; Serum protein electrophoresis; Rheumatoid factor (RF); Serum uric acid; Calcium; Phosphorus; Alkaline phosphatase; VDRL; and Joint fluid analysis (when available).
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