Bursitis - Treatment

Aseptic bursitis treatment.Conservative therapy.Most patients are treated conservatively to reduce inflammation.Conservative treatment includes rest, heat or cold treatments based on the lifting of the affected joint, anti-inflammatory drugs-NSAIDs, aspiration and injections intrabursale scholarship with steroids or local anesthetics. The affected area needs rest. Your shoulders should not be immobilized for more than a few days because of the risk of capsule adhesive. After restraining the patient gradually start exercising. Patients with bursitis in his alternate convention activities should not lead to recurrence. Apply cold treatment for 20 minutes every few hours, with effects in the first 24-48 hours. Data indicate is involved lifting his leg.Administration of NSAIDs.It is used to relieve pain. It is administered diclofenac, and 90% of patients improve after 14 days.Intrabursal steroids.With or without local anesthetic, they should not be used if infection is suspected. The wear and tear injuries injections should not replace or modify the activity causing the termination. It uses a variety of steroids: hydrocortisone, prednisolone, metilprednisolun, triamcinolone, betamethasone, dexamethasone. No agent has not been proved superior. Steroids can be mixed in the same syringe with lidocaine or bupivacaine. The therapy is reserved for patients unresponsive to other treatments.Surgery.Surgical excision of the exchange is necessary in chronic or recurrent bursitis. Surgery is reserved as a last resort for patients who fail conservative treatment. Operations vary depending on location.
Treatment of septic bursitis.Patients with septic bursitis requires antibiotic until culture results.Superficial bursitis can be treated with oral therapy. Those with symptoms or who are immunocompromised require intravenous therapy. Staphylococcus aureus is the most common pathogen number 80% of cases. Species group A hemolytic streptococcal counts 20% of cases. Other gram-negative infections, Gram-positive and anaerobic bacteria are rare. Mycobacterial infections, fungal, algae, and spirochetes are even more rare.Enter an appropriate antistaphylococcal empirically. It can be a penicillin as oxacillin, I as a generation cephalosporin cefazolin. In patients allergic to penicillin or methicillin resistant staphylococcus vancomycin is recommended. Duration of antibiotic therapy in uncomplicated septic bursitis is 7 -10 days. Repeat aspiration 1-3 days after taking antibiotics. This helps to decrease the number of bacteria and brings comfort. Imunocompromisii require prolonged therapy. Drainage and debridement may be required.
Treatment for Tuberculous bursitis.It involves complete removal of the exchange and adjacent tissues affected by concomitant antituberculous therapy for 6-12 months.Atypical mycobacteria can be treated by drainage and antibiotics.Brucella bursitis is treated with excision with or without tetracycline and rifampicin.
Surgical therapy.Surgery is not indicated in most cases of bursitis. Surgical procedures can be used to treat chronic bursitis, which is refractory to other conservative treatment is aspiration, incision and drainage, excision of chronically inflamed bursa and removing overhanging bone. The practice of injecting steroids if not responding to other treatment. In case of septic bursitis, the scholarship should be aspirated. Overlying skin is sterilized stock.Aspirated fluid is sent for analysis to search for infectious organisms or crystals. If bursitis is an aspiration secondary to infection after treatment including antibiotics.