How is Bursitis Diagnosed?

What are the signs and symptoms of bursitis?

Bursitis symptoms are there because of the amount of inflammation in the bursa, as well as the exact area of the bursa involved. The swelling causes pain and tenderness in the bursa. When the bursa is so swollen, then it can cause stiffness along with localized redness and warmth. The pressure on the body cannot be supported because of the pain caused by the inflammation. For instance, if the patient has hip bursitis, it can be extremely painful to lie on the affected hip. Taking one more example, it can be extremely difficult to lie down with the knees touching each other if the patient has inner knee bursitis.

There are various parts of the body that can be affected by bursitis because we have 160 bursae in the body. The symptoms can be manifested on the side of the hip, on the shoulder, the elbow, the knee, the buttock or the heel and foot. Because of this, it has been given various names such as housemaid’s knee, student’s elbow, and tailor’s bottom, to name a few.

Some of the most common symptoms of bursitis are swelling or pain in the affected joint. It is usual to see apparent swelling in bursae that are close to the skin surface, such as the areas around heels, kneecaps, and elbows. There are fewer signs of swelling in deeper areas namely inner knees, hips, and shoulders.

There is pain just above the affected bursa in the case of acute bursitis. Pain is also caused when the patient bends or moves the joint. Those patients that have chronic bursitis usually have swelling but with very less pain. The range of motion is quite limited due to minimal use of the muscles and movement of the joints.

Septic bursitis is a type of bursitis caused by an infection. Redness near the affected joint, swelling, warmth, and pain are the usual symptoms. There can also be fever. Septic bursitis is a serious condition, and there is a possibility of the blood or the joints being infected too. Different areas that are affected display symptoms specific to it.

How is Bursitis diagnosed?

Since bursitis causes pain in the affected area, sometimes it may be difficult to diagnose the condition. This is because the cause of the pain can be mistaken with other infections or complications. This leaves the doctor with the obligation of examining the patient carefully to identify the problem. 

Most of the doctors start diagnostic by looking at your history: how the pain started, the progress of the pain since its onset, time of its onset, and also activities that trigger or triggered the pain. The doctor will now go further into doing other tests depending on the history and even the location suspected to be under attack. Some of these tests include:

Physical Examination

In this case, you will be required to explain to your medical expert which parts of your body tissues are aching. You will show the doctor which movements increase the pain. The doctor will also want to know the time of the day when the pain varies. 

The doctor will go further into making physical examinations such as applying some pressure on the affected area to understand the stiffness. If it in shoulders, for example, the doctor will move your shoulders slowly up and down.

Physical examination may also involve touching the skin around the area to feel its warmth since bursitis causes warmth around the affected area. The doctor will also look at the area to see if it is red. The doctor sometimes may decide to use anaesthetic injection to detect bursitis. The doctor uses a normal injection on the area where the bursa is located. If the pain stops, then the bursitis condition is identified.

X-ray

After the doctor has ruled out the point of your joints that is affected, it is important to examine the bones around the area to check any bone problem that might be the cause of the pain. The X-ray is used to check any bone problems such as rupture that may also be the cause of the pain.

MRI

Magnetic resonance imaging (MRI) can be used by the doctors to identify any tear in the tissues which may be the cause of pain. This is because MRIs can be able to detect any tear in tissues such as muscles and tendons. Such a process is also used to rule out the possibility of other infections.

Lab Tests

In this case doctors use laboratory analysis of your body fluids or blood to identify bursitis and also other infections that might be causing pain in the bursa. The doctor can take and examine your blood to check for other conditions such as diabetes and rheumatoid arthritis. Fluid from the bursa is also be examined to identify gout and other infections.

Joint Aspiration and Fluid Analysis

The fluid from the bursa must be aspirated and analyzed to dismiss rheumatic infection. Doctors are usually keen to do aspiration of the bursa in the case of infrapatellar and prepatellar bursae. The presence of high protein level and lowered glucose level can also indicate infection. For diagnosis, the culture of bursal fluid is the conclusive test. Fluid medium culture is better than solid medium culture. Fluids must also be tested for crystals. In gout, there is presence of monosodium urate crystals. In psuedogout, there is presence of calcium pyrophosphate crystals. And in rheumatoid chylous, there is presence of cholesterol crystals.

The Bottom Line

Bursitis is a condition that it is common and sometimes you may confuse it with other infections. There are a times when a totally different disease is causing similar pain in the joints. People also tend to take pain caused by bursitis as a mare condition that will disappear within a short time. If someone stays with bursitis for long periods of time, without identifying it, may progress into bigger problems such as limping. It is thus very important to diagnose it as soon as possible.