Bursitis is almost always diagnosed on physical examination. Findings consistent with bursitis include:
- Tenderness directly over the bursa
- Pain with movement of overlying muscles and tendons
- Swelling of the bursa
Imaging tests such as x-rays and MRIs are not usually needed to make the diagnosis of bursitis. While they may not be needed for diagnosis of bursitis, x-rays often performed to ensure there is no other problem, such as a fracture, that could be causing the symptoms of pain and swelling. X-rays can show signs of swelling, so they may help to confirm the diagnosis of some types of bursitis. MRIs are also good tests identify swelling, and will show evidence of bursitis.
There is a risk that an inflamed bursa can become infected, especially when the bursa is located close to the skin, such as with elbow or kneecap bursitis. In situations such as hip or shoulder bursitis, where the inflammation is deeper within the body, infection is extremely rare.
If you have any sign of infection associated with bursitis you should alert your doctor immediately. These signs of infection include:
- Open wounds around the area of bursitis
- Redness of increasing warmth the skin
- Systemic signs of infection such as fevers, chills, and sweats
If there is a suspicion of infection, your doctor may obtain some of the fluid from the swollen bursa for microscopic analysis. The fluid can usually be suctioned from the bursa with a small needle and a syringe. Patients with infected bursitis will require antibiotic treatment, and may require surgical drainage of the bursa.
Treatment of bursitis depends on the specific location of the bursa, but the general focus is to rest the bursa, decrease inflammation, and allow time for recovery. Most all cases of bursitis will recovery with non-surgical management. When the bursitis is persistent despite appropriate treatment, surgical excision of the bursa is an option. In people diagnosed with infection of the bursa, a septic bursitis, there will also need to be appropriate antibiotic treatment.
Specific treatment of different types of bursitis can be found here:
Information about shoulder bursitis. Many people are told by their doctor they have "shoulder bursitis;" learn about this common diagnosis and available treatments.
Olecranon bursitis is a common cause of swelling and inflammation around the elbow joint. Usually treated easily by draining the swollen bursa, it is important that olecranon bursitis be evaluated by a physician to ensure it does not become infected.
Trochanteric (Hip) Bursitis
Trochanteric bursitis, also called hip bursitis, is a common problem of pain and inflammation over the outside of the hip and thigh area. Treatment consists of resting and medications.
Prepatellar (Kneecap) Bursitis
Prepatellar bursitis, or Housemaid's Knee Syndrome, is a condition of swelling and inflammation over the front of the knee. This is commonly seen in patients who kneel for extended periods, such as carpet layers and gardeners.