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PubMedDate not supplied

A new operative approach to snapping hip and refractory trochanteric bursitis in athletes.

This report concerns seven patients that had a painful hip due to snapping of the iliotibial band over the greater trochanter and resultant trochanteric bursitis, and whose symptoms were refractory to nonoperative treatment. An operative procedure that has not been previously described was performed. It involved the excision of an ellipsoid-shaped portion of the iliotibial band overlying the greater trochanter and removal of the trochanteric bursa. Five of the seven patients were evaluated at the time this report was prepared; the average length of followup was 55 months. Four were significantly improved or relieved of their symptoms, and the fifth was an operative failure with complete recurrence. This final patient underwent a second, more extensive partial excision of the iliotibial band, and was asymptomatic 1 year later. A review of the clinic records of the remaining two patients that could not be contacted revealed that they both had been doing well at their 6 month evaluation. For those patients with a symptomatic snapping hip and trochanteric bursitis unresponsive to conservative therapy, the procedure described is an effective method of treatment.

Adult↗
PubMedDate not supplied

Tibial collateral ligament bursitis.

In 91 patients evaluated between 1982 and 1985, tibial collateral ligament bursitis was diagnosed. This entity has not been described since the work of Brantigan and Voshell in 1943. The diagnosis was based on the findings of tenderness over the tibial collateral ligament at the joint line, without a history of mechanical symptoms. With a nonsurgical program, 62% of the patients improved and subsequently required no further treatment. Fifteen percent did not improve; of this group, one-third had a negative arthrogram or arthroscopy. Another 23% did not improve and ultimately underwent an arthroscopic partial medial meniscectomy. Tibial collateral ligament bursitis is an entity that should be considered in any patient with medial joint pain in the knee. Treatment is simple, effective, and offers low morbidity.

Adult↗
PubMed2003

Trochanteric reduction osteotomy as a treatment for refractory trochanteric bursitis.

We describe a new operative procedure for patients with chronic trochanteric bursitis. Between March 1994 and May 2000, a trochanteric reduction osteotomy was performed on ten patients (12 hips). All had received conservative treatment for at least one year. Previous surgical treatment with a longitudinal release of the iliotibial band combined with excision of the trochanteric bursa had been performed on five hips. None had responded to these treatments. The mean follow-up was 23.5 months (6 to 77). The mean Merle d'Aubigné and Postel score improved from 15.8 (8 to 20) before to 27.5 (18 to 30) after operation, six patients showing very great improvement, five great improvement and one fair improvement. We conclude that trochanteric reduction osteotomy is a safe and effective procedure for patients with refractory trochanteric bursitis who do not respond to conservative treatment.

Adult↗
PubMed1998

Iliopsoas bursitis and tendinitis. A review.

This review examines the diagnosis and management of iliopsoas bursitis and/or tendinitis. It is a relatively uncommon and unrecognised cause of anterior hip pain and anterior snapping hip. In view of its pathology, iliopsoas bursitis might be better referred to as iliopsoas syndrome. It can usually be diagnosed by history and physical examination, though real time ultrasound may be useful in confirming the diagnosis. Magnetic resonance and computerised tomography imaging have limited roles in its diagnosis, but may identify other pathology or surgical lesions. Nonoperative management has not been well established. Surgical management does not guarantee treatment success. There is a need for further research into both diagnostic and treatment options for those patients with iliopsoas bursitis/tendinitis.

Bursitis↗
PubMed2003

Rice-body formation in atypical mycobacterial tenosynovitis and bursitis: findings on sonography and MR imaging.

OBJECTIVE: This article describes rice bodies found in patients with atypical mycobacterial tenosynovitis and bursitis, emphasizing the sonographic and MR imaging appearances of these small bodies. CONCLUSION: Rice bodies occur in patients with atypical mycobacterial tenosynovitis and bursitis. When small, rice bodies are better visualized on MR imaging than on sonography, allowing the radiologist to consider appropriate diagnoses.

Aged↗
PubMed1986

Predisposing factors, bacteriology and antibiotic therapy in 35 cases of septic bursitis.

In a retrospective study the etiology was verified in 35/52 patients with suspected septic prepatellar or olecranon bursitis. Staphylococcus aureus was the most common pathogen and 86% of them were penicillinase-producing. Other strains were streptococci. Mean age was 47 (18-83) years and males predominated (91%). Predisposing factors were seen in most cases. Preceding trauma was found in 27 and/or associated diseases (e.g. diabetes mellitus) in 11 patients. Hyperglycemia was found in 38% of the patients. Treatment with antimicrobial agents, mostly penicillins, and bursal drainage were successful in 32 cases. Two patients had local spread of the infection and 1 patient chronic bursitis.

Acute Disease↗
PubMed1985

Trochanteric bursitis. Treatment by corticosteroid injection.

Thirty-six cases of simple trochanteric bursitis were evaluated, particular in regard to corticosteroid injections. The syndrome was mostly chronic, prevalent in older females, interspersed with other diseases. Diagnostic criteria are purely clinical. One or two local corticosteroid injections gave excellent response in two-thirds, improvement in the remaining cases. One-fourth relapsed in 2 years. Trochanteric bursitis should always be considered in hip pain syndromes, as it is so easily relieved.

Adolescent↗
PubMed2004

The MRI features and treatment of scapulothoracic bursitis: report of four cases.

Among cases of soft tissue tumours arising between the inferior angle of the scapula and thoracic wall, scapulothoracic bursitis has rarely been reported. All the reported cases were surgically treated and there have been no reports about the results of conservative treatment observed for a long period. Therefore, we retrospectively evaluated the clinical findings, magnetic resonance imaging (MRI) features, and treatment procedures in order to elucidate the differential diagnosis for, and efficacy of, conservative treatment. The patients were those who consulted our department of orthopedic surgery from 1994 to 1998 with complaints of thoracic back tumours. The patients were 2 men and 2 women whose ages ranged from 46 to 66 years. The tumour locations, MRI findings and treatments were evaluated. The cysts appeared in the inferior angle of the scapula with the shoulder flexed and adducted. There was neither pain nor tenderness, local heat nor redness. The cysts were elastic hard, fluctuating, and less mobile and the margins were well circumscribed by palpation. The diameters were from 6 x 6 cm to 20 x 15 cm. On MR imaging, the cysts were located between the serratus anterior muscle and the chest wall. Slightly high signal intensity on T1WI, high on T2WI and fluid-fluid levels were seen in the cysts in three cases. For the treatment, in one case we performed multiple aspirations until a reduction appeared to occur. The average aspirated contents of the cyst were 100 mL to 200 mL and were bloody-serous. In two cases no special treatments were employed, and in one case the tumour was surgically removed because it was unresponsive to aspiration. In the three cases with conservative treatment, the follow-up time was 8, 9 and 25 months, respectively. The tumours had disappeared in all cases at the time of the final follow-up. High signal intensities on T1 and T2 weighted images, and fluid-fluid level on T2 weighted images were very useful MRI features for the diagnosis of scapulothoracic bursitis. Our observations indicate that conservative treatment can be successful and surgery is not necessary except for cases with pain, excessive friction, or dysfunction.

Adult↗
PubMed2002

Tuberculous subdeltoid bursitis with rice bodies.

A 41-year-old woman with a 2-month history of diffused swelling and persistent dull pain in her right shoulder was examined. Magnetic resonance imaging (MRI) findings revealed subdeltoid bursitis and rice bodies with normal surrounding tissue and shoulder joint. Arthoscopic debridement and biopsy of the subdeltoid bursa were performed. Histologic examination of the bursal tissue showed granulomatous tissue with typical caseous necrosis. A positive culture of Mycobacterium tuberculosis confirmed the diagnosis of tuberculosis. We report on the clinical, radiological and athological findings in a patient with tuberculous subdeltoid bursitis accompanied by multiple rice body formation without coexisting active bone and joint tuberculosis, and conduct a literature review.

Adult↗
PubMed1991

Septic bursitis: experience in a community practice.

We reviewed 47 episodes of septic bursitis occurring in a private community medical practice. Most patients were male (85%), and roughly half (49%) the cases were related to recreational or occupational trauma. About 72% of cases were located in the olecranon bursa, while the remaining cases were prepatellar. Prepatellar bursitis patients were more likely to be hospitalized. Staphylococcus aureus was isolated from 70% of bursal fluid aspirations; other etiologic organisms included gram negative bacteria and Mycobacterium marinum. The majority of patients were able to be treated as outpatients with oral antibiotics. All patients were eventually cured without serious complications.

Adolescent↗
PubMed2000

Anserine bursitis in patients with osteoarthritis of the knee.

BACKGROUND: We sought to determine the frequency of anserine bursitis (AB) in Koreans with osteoarthritis (OA) of the knee and its relationship to age, sex, and radiographic severity of OA, and to evaluate its response to various forms of therapy. METHODS: In a retrospective study, we reviewed the charts of patients with OA of the knee and graded the radiographic severity by the Kellgren-Lawrence grading scheme. RESULTS: Of 62 patients, 29 had AB. No difference in age, sex, and radiographic severity was noticed between patients with AB and those without AB. Eleven of 12 patients who received a local injection of methylprednisolone plus lidocaine at the anserine bursa had relief, whereas 7 of 17 patients who received noninjection therapy for AB showed improvement. CONCLUSIONS: Anserine bursitis is commonly found in Koreans with OA of the knee, and its presence is unrelated to age, sex, and radiographic severity. Local injection at the anserine bursa is more effective than noninjection therapy.

Anesthetics, Local↗
PubMed2000

Arthritis, tenosynovitis, fasciitis, and bursitis due to sea urchin spines. A series of 12 cases in Réunion Island.

UNLABELLED: Arthritis, tenosynovitis, and bursitis due to sea urchin spine injuries have unique pathological features and run a chronic course until the spines are removed. Of the 40 cases of sea urchin spine-related clinical symptoms published to date, only 12 had osteoarticular symptoms. PATIENTS AND METHODS: We studied 12 cases with osteoarticular symptoms seen in Réunion Island from 1994 to 1998. There were nine cases of arthritis and one case each of tenosynovitis, fasciitis, and bursitis. The nine males and three females had an age range of 9 to 50 years. RESULTS: The injury was at the knee in six cases, the foot in three, and the hand in three. The time from injury to lesion development ranged from two days to two and a half months. Laboratory tests were normal apart from evidence of mild inflammation in three of the arthritis cases. The spine was visible on plain radiographs in eight cases. Histology was done in seven patients and consistently showed a typical foreign body granuloma. Removal of the spine with synovectomy was performed in 11 cases and consistently ensured a full recovery. DISCUSSION: The clinical manifestations and management in our patients were compared to those in earlier reports. The differential diagnosis of laboratory test, radiographic, and histologic findings is reviewed. Pathogenic hypotheses and the immunogenic effect of the protein sheath that surrounds sea urchin spines are discussed. CONCLUSION: The diagnosis of these frequently under-recognized lesions rests on a careful history and on converging histologic, radiologic, and clinical findings.

Adolescent↗
PubMed2002

[Tuberculosis bursitis: report of case].

We report a previously healthy 51 years old woman with a one year history of pain in the left hip associated with a mass without fever or local inflammatory changes. Magnetic resonance imaging located the mass in the medial gluteal muscle. The pathological examination of the mass disclosed unspecific inflammatory changes. Due to worsening of pain, a left throchanteric bursitis was diagnosed two weeks later and a throchanteric bursectomy was performed, obtaining a second biopsy. Aerobic, anaerobic and fungal cultures were negative. Lowenstein-Jensen culture showed development of mycobacteria and a genetic probe confirmed the presence of Mycobacterium tuberculosis. The second biopsy also identified several granulomas with areas of caseation and the Ziehl-Nielsen stain was positive for acid fast bacilli. Osteoarticular tuberculosis, specially bursitis, should be suspected in the presence of chronic pain associated with swelling.

Bursitis↗
PubMed2003

[Rapidly destructive hip disease with resultant iliopectineal bursitis].

A man aged 72 years developed complete destruction of his right hip joint within 12 weeks: 'rapidly destructive hip disease' (RDHD). Analysis of weight loss also revealed iliopectineal bursitis. Nine months after total hip arthroplasty, the patient was free of complaints and the bursitis had disappeared. The cause of RDHD is unclear. Associations have been made with osteonecrosis, chondrocalcinosis and arthropathies of other joints. The destruction of the acetabulum and the femoral head can lead to hydrops in the hip joint and, via a communication between the joint and the iliopectineal bursa, to inflammation of the bursa. This combination of diagnoses has not been described before.

Aged↗
PubMed1991

"Pseudotrochanteric bursitis": the differential diagnosis of lateral hip pain.

Eighteen patients who were initially diagnosed as having trochanteric bursitis refractory to conventional therapy are reported. The most common causes of pseudotrochanteric bursitis were lumbar radiculopathy (L2, L3), lumbar facet syndrome with pain referred to the lateral thigh, and entrapment neuropathies involving the subcostal, and the lateral cutaneous branches of the iliohypogastric nerves. Less common causes were undisplaced femoral neck fracture, adiposa dolorosa, and hip abductor muscle strain. Diagnosis was facilitated by selective neuroblockade.

Adult↗
PubMed1990

Mycobacterial prepatellar bursitis.

Prepatellar bursitis secondary to infection with an atypical mycobacterium developed in an 88-year-old man. A review of all previously reported cases in the English literature indicates tuberculosis is important in the differential diagnosis of prepatellar bursitis.

Aged↗
PubMed1989

[Treatment of suppurative bursitis].

In the last decade 323 patients were operated on in the clinic for purulent bursitis; the abscess was opened and the dressing was changed daily. With the traditional method of treatment, the duration of management was 22.9 +/- 3.5 days in each patient. A method is suggested for the treatment of acute purulent bursitis by fraction irrigation of the purulent cavity by means of a drainage-irrigation system based on the puncture techniques. It was applied in 42 patients and shortened the duration of their treatment to 9.3 +/- 2.3 days, i. e. almost by 2.5 times. Moreover, a good functional and cosmetic effect was produced.

Acute Disease↗