Fast Five Quiz: Joint Pain

Herbert S. Diamond, MD

Disclosures

February 12, 2019

Subacromial bursitis is frequently associated with supraspinatus tendinitis because inflammation extends from one structure to the other. Repetitive activities with an elevated arm most frequently cause inflammation of the bursae. Examples of this include frequent pitching of a baseball or lifting luggage overhead. Less commonly, a primary process, such as rheumatoid arthritis, gout, or tuberculosis, may lead to bursitis.

Reduced active range of motion with preserved passive range of motion is suggestive of bursitis, but the differential diagnosis includes tendinitis and muscle injury. A decrease in both active and passive range of motion is more suggestive of other musculoskeletal disorders. In patients with chronic bursitis, the affected limb may show disuse atrophy and weakness. Tendons may also be weakened and tender.

Although septic bursitis is not diagnosed solely on the basis of clinical signs, certain signs tend to favor the diagnosis of septic over sterile inflammatory bursitis. In particular, patients with septic bursitis may have fever, bursal warmth, tenderness that is more severe than in nonseptic bursitis, and associated peribursal cellulitis. Joint motion is typically preserved in septic bursitis, whereas other types of bursitis are associated with limited range of motion.

Read more information about the presentation of bursitis.

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