chronic traumatic bursitis
Introduction
Introduction to chronic traumatic bursitis Bursitis is an acute and chronic inflammation of the bursa. Clinically, it is most common in chronic aseptic bursitis, which is related to long-lasting friction and compression. The bursa, also known as the synovial sac, the synovial sac or the sac, is an accessory structure of the muscle and tendon as the tendon sheath, and is a connective tissue sac. Most of the bursa are independent, and a few are connected to the joint cavity. All parts of the human body that have frequent friction or high pressure have sacs, which are often present between the two friction surfaces of the tough structure of the human body, such as bone protrusions, muscles, tendons, ligaments or skin. The wall of the sac is divided into two layers, the outer layer is thin and dense fibrous connective tissue, but does not form an envelope. The inner layer is synovial endothelial cells, which originate from the original mesenchymal tissue and have the function of secreting synovial fluid. basic knowledge The proportion of illness: 0.002% Susceptible people: more common in middle-aged and elderly people Mode of infection: non-infectious Complications: muscle atrophy
Cause
Causes of chronic traumatic bursitis
(1) Causes of the disease
There are many kinds of sacs in the human body, and they are widely distributed. The sacs are divided into two types, some of which are constant. They have formed in the fetal period, which is called constant sac. There are more than 100 whole body, and the important ones are the scapula of the upper limbs. The olecranon sac, the large trochanteric sac of the lower extremity, the ischial tuberosity sac, the anterior sac sac, the posterior sac, etc., and the other part is the indeterminate sac, which varies from person to person and is more in order to adapt to the physiology. Or the pathological friction needs to be secondary, called the friction sac or the additional sac, the wall of which is mostly derived from fibrous tissue, which is much thicker than the wall of the constant bursa.
According to the location of the bursa, it can be divided into a skin sac, a sac sac, a muscle sac, a fascia sac, a ligament between the ligaments, and a joint sac.
Bursitis is an acute, chronic inflammation of the bursa, according to its etiology and nature, can be divided into traumatic bursitis, suppurative bursitis, tuberculous bursitis, rheumatoid bursitis, gouty bursitis , chemical bursitis and so on.
Clinically, chronic aseptic bursitis is the most common, and is associated with long-lasting friction and compression.
(two) pathogenesis
When the bursa is subjected to excessive friction and/or compression, an inflammatory reaction occurs in the wall of the sac, the secretion of synovial fluid increases, and the exudation of the cyst wall increases, causing the sac to expand and swell, and the effusion in the acute phase is bloody. After the red blood cells rupture, hemosiderin deposition, synovial fluid is yellow; to the chronic phase, the sac fluid can be normal mucus, but the cyst wall hyperplasia, hypertrophy, fibrosis, synovial hyperplasia can be villous, and some capsules Calcium deposition at the bottom can affect joint activity.
Prevention
Chronic traumatic bursitis prevention
1. Pay attention to hygiene: Strengthen labor protection and develop the habit of washing hands with warm water after work.
2. Pay attention to rest: Rest is the primary method to solve any joint pain, so the joint should be well rested.
3. Ice: If the joint is hot to touch, you can use the ice method. Take 10 minutes of ice and 10 minutes of rest. Do not use hot compress as long as the joint is still hot.
4. Alternation of ice and heat: If the acute swelling and pain is weakened and the heat has been eliminated, it can be treated by alternating hot and cold methods, that is, after 10 minutes of ice application, the heat is applied for 10 minutes, and so on.
5. Swing arm: If the pain is on the elbow or shoulder, it is recommended to swing the arm freely to relieve the pain.
Complication
Chronic traumatic bursitis complications Complications muscle atrophy
Chronic bursitis can be developed after multiple episodes of chronic traumatic bursitis or repeated trauma. The episode lasts for several days to several weeks and recurs many times. Acute symptoms can occur after abnormal exercise or excessive force. As the synovial membrane proliferates, the wall of the sac becomes thicker, and the sac becomes eventually stuck, forming villi, sputum and calcium deposits. Muscle atrophy and limited mobility due to pain, swelling and tenderness.
Symptom
Chronic traumatic bursitis symptoms Common symptoms Trauma
1. General symptoms Clinical chronic traumatic bursitis can be seen in any age and various occupations, more common in middle-aged and elderly people, but there is excessive friction in this part, compression history, the main clinical manifestations of masses and pain, no painful mass Mostly, it is unintentionally discovered during bathing, etc. Sometimes a mass can affect joint activity or oppress the surrounding nerves to cause discomfort.
2. The size of the tumor varies from site to site, round, cystic, and non-adhesive to the skin. The hardness of the mass is related to the pressure inside the capsule. Most of them are hard, the boundary is clear, a few are soft, the boundary is unclear, and the mass is not tender or Only mild tenderness, spontaneous pain is rare, symptoms can be aggravated by friction, pressure, etc., and more can be relieved after rest.
Examine
Examination of chronic traumatic bursitis
During the examination, the localized tenderness on the bursitis should be ascertained. For the shallow bursa (such as the olecranon, anterior iliac crest), a certain swelling and no synovial fluid should be examined. If the patient has obvious pain, redness, fever and swelling, To rule out infection, it is necessary to exclude lacerations of tendons or muscles around the joints, suppurative bursitis, intracapsular hemorrhage, synovitis, osteomyelitis and cellulitis. The pathological process can involve the same sac and joints.
Diagnosis
Diagnosis and diagnosis of chronic traumatic bursitis
According to the medical history, occupation, age, local symptoms, physical examination of the mass and B-ultrasound, X-ray examination, if necessary, the mass can be puncture, the diagnosis can be established.
