BURSITIS

QUESTIONS AND ANSWERS

Risk Factors

Bursitis can affect anyone including children and older people. However, it is more common in women and elderly or middle-aged people. It is rarely found in men and younger individuals. Here are the following risk factors commonly associated with the development of bursitis.

• Leg-length inequality: When one leg is way shorter than the other, it badly impacts the way your child walks and may lead to hip bursa irritations.
• Rheumatoid arthritis: A condition like this makes the bursa more susceptible to becoming inflamed.
• Previous surgery: If any surgery is done around the hip or there are prosthetic implants in the hip, it can irritate the bursa causing bursitis.
• Bone spurs or calcium deposits: Often these elements develop within the tendons that attach muscles to the trochanter. These spurs and deposits often irritate the bursa causing inflammation.
• Spine disease: For example – Arthritis of the lumbar (lower) spine, scoliosis, and other spine problems that may affect the way your child walks.
• Overuse or Repetitive Stress Injury: This can occur while bicycling, running, stair climbing, or standing for a prolonged time.
• Hip injury: When your child falls straight onto his or her hip, bumps their hip in a bad way, or lies on one side of their body for a long time, an injury at the point of their hip can occur.

Causes 

Things that often lead to bursitis are:

• Bacterial infection, such as staph infection (Staphylococcus aureus)
• Diabetes
• Stress or Repeated overuse
• Rheumatoid arthritis
• Spine problems, such as scoliosis
• Uneven leg lengths
• Bone spurs
• Gout
• Pseudo gout
• Hip Injury

Prevention

Doctors report that people cannot prevent bursitis 100% of the time.  However, there are certain things parents can do to prevent the problem from getting worse.

• Avoid your child from repetitive activities, especially those that put stress on the hips.
• Your child should lose weight if overweight
• Your child should conduct strength and flexibility-building exercises for the hip muscles.
• For your child’s leg-length differences get a proper shoe insert.

Diagnosis 

To accurately diagnose bursitis, doctors perform various types of physical examinations to look for tenderness at the point of the pain. Also, doctors may request additional tests to figure out other underlying injuries or conditions. The tests usually performed are imaging studies, such as X-rays, bone scanning, and magnetic resonance imaging (MRI) scans.

Nonsurgical Treatment

In the initial stage, bursitis treatment does not involve any surgery. In most cases, people with bursitis get relief by implementing simple lifestyle changes or with a minor procedure, such as:

• Modifying Activity – Stop doing activities that worsen symptoms.
• Nonsteroidal anti-inflammatory drugs (NSAIDs). Doctors may often recommend celecoxib, Ibuprofen, naproxen, piroxicam, and others. These medications help relieve pain and inflammation.
• Supportive devices – Using crutches or a walking cane for a week or more if required.
• Physical therapy – Doctors often prescribe exercises that focus on stretching out the IT band and/or increasing hip flexibility and strength. Your child may try doing these exercises or visit a physical therapist. They will teach your child how to properly stretch the hip muscles and safely practice other treatments such as heat, ice, or ultrasound.
• Steroid injection – Injection of a corticosteroid with a local anesthetic seems to help relieve symptoms of hip bursitis. A single injection into the bursa may provide temporary (months) or even permanent relief. In case the pain and inflammation return, taking another injection after a few months may further reduce bursitis.
• We often empty the bursitis fluid.  Typically, the bursa sac is punctured with a needle, and the fluid is drawn out relieving the pressure and pain. To increase precision and avoid harming adjacent structures, the needle is guided under ultrasonography. To avoid fluid re-accumulation, we inject a modest amount of cortisone last. Overall, due to the increased risk of infection, we exercise caution when using invasive therapies for bursitis. Instead, the majority of instances will simply require straightforward therapies.

Surgical Treatment

Well, surgery is hardly necessary for treating bursitis. If the bursa remains inflamed and painful even after trying all sorts of nonsurgical treatments, only then our doctors recommend surgical removal of the bursa. Removing the bursa does not hurt the joint, and after surgical removal, the joint can function normally. Arthroscopic removal of the bursa is a new technique that is gaining popularity. In this technique, the surgeons remove the bursa by making a small (1/4-inch) incision over the hip. Then they place a small camera or arthroscope in a second incision. This camera guides the doctors to use miniature surgical instruments and remove the bursa. This surgery is minimally invasive, and therefore, the recovery is quicker. Also, it is less painful, unlike open surgery.

Surgeries are usually performed on an outpatient (same-day) basis. That is why an overnight stay in the hospital is not mandatory. Determining the underlying reason for bursitis is crucial to get the right treatment.

Rehabilitation

Doctors recommend that patients conduct a short rehabilitation period after surgery. It is necessary to walk around the evening after the operation. For most patients, using a cane or crutches for several days helps. After a few days, the pain from surgery generally reduces.

Get Care

When parents come to us with their children in pain, we carefully evaluate them and assess the severity of the problems. From consultation to treatment – the parents will get a comprehensive solution from our team at Medical City Children’s Orthopedics and Spine Specialists.

Bursitis Types

Hip Bursitis

Hip bursitis sometimes referred to as greater trochanter pain syndrome is inflammation of the bursa, which serves as a cushion between the bone and the tendon and muscle of the hip. Children can develop bursitis in several areas of the body, such as the shoulders, knees, or elbows because an adult’s body includes 160 bursae (plural of bursa). Hip bursitis can affect the bursa within or outside of your child’s hip. The location of the afflicted bursa and whether or not it is infected will determine the type of hip bursitis your child has. Bursitis may be one condition affecting the shoulders, knees, or elbows, but there are other reasons for pain in those areas; so a full diagnosis must be made by a children’s doctor. The following are the main kinds of hip bursitis:

Trochanteric Bursitis

The bony protrusion on the outside of your child’s hip, just above the thighbone, is known as the trochanter. It’s possible that the outside of your child’s hip and outside thigh will hurt.

Iliopsoas Bursitis or Ischial Bursitis

An irritated bursa on the groin side of the hip can occasionally cause discomfort in the upper buttock or groin.

Septic Hip Bursitis

Septic hip bursitis results from an infected bursa. Doctors report that hip bursitis can be accompanied by additional symptoms including fever, fatigue, and sickness. A tendon injury or persistent rubbing or pressure inside the hip can result in bursitis, a hip inflammation. The most typical reason for hip discomfort is hip bursitis. Medical City Children’s Orthopedics and Spine Specialists can assist parents, whether they are knowledgeable about hip bursitis or are unsure of what is causing their child’s discomfort. The orthopedic specialists on our staff can determine the cause of your child’s discomfort and provide specialized care that can bring your child relief. Physical therapy is part of the treatment strategy to help your child regain the full range of motion.

Knee Bursitis

Bursitis in the knee refers to swelling or inflammation of the bursa, a little sac filled with fluid that sits either between the skin and the tendon or the tendon and the bone. Bags are referred to in Latin as “bursae.” Different bodily joints are padded by these bags, which function as miniature pillows. According to a 2018 study, these sacs swell up and cause bursitis. A condition known as effusion may occur where fluid gathers around the joint. When your child rests their knee on a hard surface, the bursae in the knee serve to protect it. As a result, there is less friction between the soft tissue and the bone. the human body has more than one hundred bursae.

Bursae can expand and become inflamed when there is too much pressure exerted on them, whether from overuse or a direct hit. Knee bursitis symptoms include touch-sensitive discomfort around the knee as well as any visible or palpable swelling around the joint. Around your child’s knee, they could feel pain, erythema, or warmth. Children may experience chills and a fever in addition to septic bursitis. Bursitis is most frequently caused by repeated, persistent pressure on a joint. It affects the knees or elbows in 1 in 10,000 persons each year. Prolonged kneeling during activities is the primary cause of knee bursitis. Because housemaids would spend so much time on their knees during work, knee bursitis is also known as a housemaid’s knee.

Elbow Bursitis

Inflammation of the fluid-filled sac at the back of the elbow is known as elbow bursitis, sometimes known as olecranon bursitis. When it first appears, it frequently looks like a soft bump, but it can also hurt. So, what exactly is an inflamed bursa in the elbow, and how can we treat it? A bursa, which develops around bony prominences like the elbow and knee, is a bag of fluid. The sac is usually quite thin and permits the mobility of bony prominences, such as those behind the elbow. On the other hand, elbow bursitis can develop when this bursal sac in the elbow thickens as a result of excessive pressure or movement. Known also as olecranon bursitis, the bursa develops on the point of the elbow.

Signs and Symptoms

The elbow’s tip swelling is the most typical sign. Sometimes patients complain of stiffness or mobility restrictions together with discomfort in the back of the elbow. Direct pressure at the back of the elbow causes pain to worsen. Additionally, elbow bursitis, commonly referred to as septic bursitis, can become infected in rare circumstances. A fall on the elbow or any abrupt trauma might result in bursitis. Bursitis, on the other hand, could appear out of nowhere. A swollen bursa sac in the elbow is also more prone to develop in those who rest their elbows on hard surfaces, such as office workers. After a skin cut, elbow bursitis may get infected, allowing bacteria to proliferate and spread.

It is more probable to get septic elbow bursitis if your child has certain conditions like gout or rheumatoid arthritis. Doctors can reduce the swelling and irritation caused by an enlarged bursa in the elbow with straightforward therapies. Parents can reduce swelling with ice and compression. Ibuprofen and other oral anti-inflammatory medications reduce bursitis pain. Most essential, persons with elbow bursitis need to recognize that treatment for the illness depends on rest and continued anti-inflammatory measures. Occasionally, despite simple therapy, an elbow bursa that is painful and swollen grows worse.

Why Medical City Children’s Orthopedics and Spine Specialists

Medical City Children’s Orthopedics and Spine Specialists doctors are experts in the management of Bursitis in Children. We help children with Bursitis conditions because we have the greatest medical professionals and cutting-edge facilities. If your child is suffering from Bursitis, please call the Medical City Children’s Orthopedics and Spine Specialists as soon as you can and make an appointment for your child.

Finally, your doctor will also learn as much as possible about your family’s medical history.  This information can lead to better health care for your child. We are here to help and when it comes to children and their health, we are specialists in this area. Parents should choose Medical City Children’s Orthopedics and Spine Specialists, with offices in Arlington, Dallas, Flower Mound, Frisco, and McKinney, Texas.  At our Medical Practice, our doctors specialize in kids and treat those with Bursitis. First and foremost, our team of highly skilled and experienced pediatric orthopedic and spine specialists is dedicated exclusively to caring for infants, children, and adolescents.

Conclusion

Our Doctors will ensure that your child receives the most tailored and age-appropriate treatment available. Additionally, our practice utilizes cutting-edge diagnostic technologies and offers the latest advancements in bone tumor treatment.  This includes minimally invasive procedures, ensuring the best possible outcomes. Finally, we understand the unique emotional and physical needs of young patients and their families, providing compassionate, family-centered care every step of the way. With a commitment to excellence in pediatric orthopedics and spine care, we strive to give your child the best chance for a healthy and fulfilling future.

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Footnote:

WebMD: Bursitis