Bursitis, Causes, Pathophysiology, CM, Management.pptx

BURSITIS

1. BURSITIS

2. INTRODUCTION TO BURSA AND FUNCTIONS Bursae are small fluid filled sacs located around joints, bony prominences, muscles, tendons and ligaments. They work to facilitate movement by creating a cushion and reducing friction between structures.

3. Elbow Bursae

4. FUNCTIONS To prevent friction between two structures like tendons and bones that is liable to be rubbed against each other. To prevent wear and tear of muscles and tendons. To protect the structures from pressure and injury.

5. It occurs because of bacterial infection or mechanical irritation. Because of which the bursitis may be infective or irritative caused by excessive pressure or friction. Also sometimes due to gouty deposit. It can affect any joint, but is most common in the shoulders, hips, elbows or knees.

6. TYPES OF BURSA True bursa: are normally present in the body at certain important situations like beneath the acromion, elbow, knee, heel. False bursa: are also called as adventitious bursa. They develop due to external trauma, pressure.

7. DEFINITION Bursitis is an inflammation of the bursae.

8. COMMON SITES OF BURSITIS Upper Limbs — Sub-acromion — Olecranon

9. Lower Limbs — Pre-patellar — Tendo -Achilles — Medial side of the great toe — Lateral side of the little toe — Hip/ Trochanteric 9

10. RISK FACTORS Age: Bursitis becomes more common with aging. Occupations or hobbies: risk of developing bursitis increases in work or hobby that requires repetitive motion or pressure on particular bursae. Examples include carpet laying, gardening and playing a musical instrument etc. History of other medical conditions: certain systemic diseases and conditions (rheumatoid arthritis, gout and diabetes). Overweight can increase the risk of developing hip and knee bursitis.

11. CAUSES • Trauma may be due to a single blow or repetitive trauma. • Infection (acute or chronic) e.g. tuberculosis. • Metabolic disorders, For example gout. •Abnormal external pressures, For example, hip ischial-tuberosity in prolong sitting. • Inflammatory disorders, such as rheumatoid arthritis. • Unaccustomed activity, exercise or ill-fitting shoes etc. •Due to excessive pressure, friction.

12. PATHOPHYSIOLOGY Due to etiological factors Infection and inflammation Pain and swelling 12

13. CLINICAL FEATURES Pain Fever Edema Redness Tenderness Painful and reduced joint range of motion Troubling moving the joints Limping is seen in gluteal bursitis

14. DIAGNOSTIC EVALUATION History collection Physical examination X- ray shows calcified bursa MRI and ultrasound Biopsy : to rule out the causes Lab tests: to rule out for signs of infection.

15. MEDICAL MANAGEMENT Medications include nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids for inflammation Salicylates or NSAIDS e.g., Ibuprofen, Aspirin Corticosteroids e.g., Prednisone Analgesics for pain Antibiotics are used to treat septic bursitis 15

16. NURSING MANAGEMENT Apply cold or heat therapies as ordered; protect the patient’s skin when applying therapies Encourage rest of the affected area, including immobilization if indicated Elevate the affected area and apply gentle compression (elastic bandage or compression or neoprene sleeve) Inspect the area for changes in swelling or erythema 16

17. Contd.. Encourage the patient to participate in self-care to the extent possible, and provide extra time for activities and assistance as necessary Administer medications, such as NSAIDs and analgesics, as ordered Encourage the use of active ROM exercises; reinforce participation in physical therapy as appropriate and indicated 17

18. Teach the patient about the disease and how to prevent future episodes Educate the proper intake of medications. Educate the patient to reduce body weight. 18

19. PREVENTION Use cushions or pads when resting a joint on a hard surface, like if kneeling or sitting. If playing sports, mix things up do not make the same motions all the time. Warm up and stretch before playing, and always use proper form. Clean any cuts on elbows and knees to prevent infections

20. Contd.. Warming up and stretching before strenuous activities to protect the joints from injury. Take breaks often when making the same motions over and over again. Use good posture all day. Keep a healthy body weight. If something hurts, stop doing it and consult with the doctor. Exercising: strengthening your muscles can help protect your affected joint.