Purulent bursitis - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Musculoskeletal System.

purulent bursitis - a purulent inflammation of the synovial bags.Bursa located around large joints and in the projection of large tendons, represent a closed cavity filled with a small amount of synovial fluid.The function of the joint capsule is to reduce friction and mechanical impact between the tendons, muscles and bones during movement in the joints.For this reason, the joint capsule is constantly exposed to mechanical stress often affects inflammatory processes.Germs get into the bursa with an open injury, as well as purulent lesions located in the neighborhood (subcutaneous cellulitis, erysipelas, boils, purulent arthritis, and others).

Causes of purulent bursitis.

purulent bursitis develops due to bacterial infections of the bag.The causative agents are mainly staphylococci and streptococci.Bursitis development is preceded, in most cases a mechanical injury.Microorganisms obtained penetrate skin abrasions and scratches in the cavity of the bag.Direct damage to the bursa almost all cases leads

to the development of the inflammatory process.Thus in the initial stage is the inflammation or serous catarrhal character.In the absence of proper treatment, the process proceeds to the stage of purulent inflammation.With inadequate treatment process can take a chronic course.

Often the disease is professional in nature, related to the forced position with a support on the elbows, knees (eg, engravers, artists, porters with long-term burdens on the shoulder).And also there during prolonged static position to support them at the time of alcohol or drugs.

presence of adjacent foci of infection, pustular skin lesions (pyoderma) can independently determine the progression of the disease, and contribute to a more rapid transition to a purulent stage after mechanical injury.

Symptoms of purulent bursitis.

most commonly affected bags elbow, knee and shoulder joints.

happens it increase in size and in the joint formed by a well-outlined swelling, usually painless, firm to palpation and does not hamper the movement of the joint, in the projection which it is With the development of serous inflammation of the joint capsule due to fluid accumulation in the lumen of the bag.

Upon accession infection, pain in the area of ​​swelling, the skin over it is red, becomes hot to the touch, there is a swelling of the surrounding tissue, the body temperature rises to 37.5 ° C and above.Redness and swelling may extend beyond the boundaries of tumor formation, suggesting the possibility of the spread of purulent process in the surrounding bursa anatomical structures.If there is penetrating into the cavity wounds bag from her purulent discharge (pictured below) can be supplied.

Photo1.Purulent bursitis elbow

Photo 2. Acute bursitis of the knee

This clinical picture is characteristic of bursitis of the knee and elbow joints.When the elbow bursitis swelling will be located on top of the elbow, with knee bursitis - on the anterior surface of the patella (prepatellyarny bursitis).

With the defeat in the area of ​​the shoulder joint synovial bags, pain with abduction and rotation inwards of the upper limb, which is associated with the location of bags under the muscles that perform these movements.Mobility shoulder purulent inflammation of the nature of the pain and pressure pus limited.There smoothing intermuscular grooves in the joint, the increase in joint volume, but only along the outer surface of the shoulder.

survey at a purulent bursitis.

If you have any of these symptoms should consult a surgeon clinics in the community.It is necessary to hand over a blood on the general analysis and the level of glucose (sugar), blood and urinalysis.Determination of blood glucose level is necessary to exclude the presence of diabetes, and determining if any degree and correction treatment.Instrumental methods of examination are used rarely because of a clear clinical picture.However, in cases of doubt and bursitis atypical location (for example, in the hip) is possible to use additional methods of research.The latter include the joint radiography and ultrasonography.

joint radiography eliminates the inflammation in the joint cavity itself.Ultrasonography sets the location and size of the cavity, allows you to perform diagnostic puncture under ultrasound control.

cavity puncture the joint capsule to evaluate fluid content to determine its nature.

only disease with which to differentiate pyogenic bursitis - a purulent arthritis.The difference between them lies in the preservation movement in the joint bursitis.Arthritis movement sharply painful and limited.When bursitis pain felt around the joint, rather than inside.

treatment of septic bursitis.

Conservative treatment of acute bursitis is only possible if the character of serous inflammation.In such cases, the arm is immobilized on a scarf, perform puncture the joint capsule of the evacuation of the liquid contents, the bag cavity is washed with an antiseptic solution.Next on the Bursa impose a pressure bandage elastic bandage.

To accelerate resorption prescribe physiotherapy: dry heat, UHF-therapy, ultrasound therapy and others.

When purulent nature of the process is necessary to open the purulent focus with partial excision of the walls of the bag, involved in the inflammatory process, treatment with oral antiseptic solutions and keeping open wounds that heal by secondary intention.Often healing occurs slowly with fistula formation with serous discharge, due to the fluid production of the bag.

When recurrent course of purulent bursitis shown complete excision of the bursa.In the postoperative period prescribed antibiotic therapy, physiotherapy and painkillers.

complications of purulent bursitis.

In the absence of timely treatment occurs purulent fusion of the walls of the bursa and the process extends to adjacent structures.As a result, developing:

• abscess - purulent fusion of subcutaneous and intermuscular cellular spaces, accompanied by the transfer of redness and swelling of the surrounding skin;
• lymphangitis - inflammation of the lymphatic ducts of the skin, which becomes visible in the form of a mesh or ducts of red color on the skin directed centripetally from a purulent focus;
• lymphadenitis - an inflammation of the lymph nodes to which lymph flows away from a purulent focus, may result in the formation of an abscess;
• suppurative arthritis - the transition of purulent process in the neighboring joints in violation of its mobility.

Prevention of purulent bursitis.

only way of prevention is to prevent traumatic impact on the area of ​​synovial bags, timely treatment of septic processes in the joints.

The use of folk remedies is not rational, since lead to the progression of purulent process and the development of complications.Therefore self is dangerous and can lead to tragic consequences.

positive outcome in this disease is only possible when early treatment for medical help.Take care of your health.It is better to overestimate the severity of your symptoms, rather than later, seek medical attention.

Surgeon Thews DS