Disorders of the Musculoskeletal System

Introduction

The musculoskeletal system aims to support, protect, and promote the movement of the body. Due to certain external factors, lifestyle preferences, and other choices people make every day, a number of disorders may challenge the work of this system. Bursitis is one of such types of disorders that is caused by trauma, infection, or other related diseases. It is usually defined as the inflammation of a bursa, a fluid-full sac with space for one tissue to slide over another tissue (Ruangchaijatuporn, Gaetke-Udager, Jacobson, Yablon, & Morag, 2017). This process frequently occurs in hips, shoulders, elbows, or knees, causes pain, and limits mobility. According to the results of the findings by the Institute for Quality and Efficiency in Health Care (2018), annually, approximately 1 in 10,000 people have bursitis-related problems, and one-third of these cases are due to bacterial infections. Men who perform manual labor like plumbers or mechanics, runners, and the elderly are at great risk for having this disorder due to their occupational and age-related health changes. This work focuses on pathophysiology and assessment of bursitis to develop an effective treatment plan, education, and follow-ups for patients.

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Pathophysiology

The bursa is the sac with a number of synovial cells that are responsible for collagen and fluid formation. The bursal lining works properly until the sac is filled with fibrin-rich fluid, becomes hemorrhagic, and is compressed against bones or muscles, causing pain and the inflammation (Williams & Sternard, 2019). There are three stages of bursitis: acute, chronic, and episodic. During acute bursitis, inflammation results in thickening of the synovial fluid. Episodic bursitis has the same characteristics as the acute one if no care and treatment are offered. Chronic bursitis occurs when ligaments are weakened, and tendons are ruptured because of repetitive pressure (Williams & Sternard, 2019). In the majority of cases, chronic bursitis remains painless because of enough time for the bursa to be accommodated with the increased or absent fluid in the sac.

Physical Assessment

When people experience pain with movement, feel stiff in shoulders, knees, or hips, observe some skin changes in these areas, or suffer from unexplainable fever, they have to see a doctor and be assessed. Physical examination begins with checking tenderness and should be supported by imaging to narrow down a diagnosis (Williams & Sternard, 2019). Ultrasound can be used to measure the bursa and observe the condition of bursal walls (Ruangchaijatuporn et al., 2017). In many cases, the inflammation may be caused by bacteria, and it is necessary to take lab tests to check the condition of the blood and analyze the quality of fluid in the bursa (Institute for Quality and Efficiency in Health Care, 2018). Each stage of physical assessment cannot be ignored because it contributes to further diagnosis and the development of a treatment plan.

Treatment

In healthcare settings, there are several approaches to help patients with bursitis. Some people believe that this type of disorder can be treated on its own by applying such methods as rest and ice. From the medication point of view, doctors and patients choose to take pain relievers to reduce the level of pain without quitting routine affairs in acute or episodic forms of bursitis (Institute for Quality and Efficiency in Health Care, 2018). Injections are offered as a quick pain killer when other medications do not work effectively. If pain comes back, and the condition gets worse, the inflammation of the bursa (chronic bursitis) has to be treated by antibiotics (Institute for Quality and Efficiency in Health Care, 2018). Physical therapy is recommended to strengthen muscles and prevent bursitis’ recurrence. The treatment plan may include surgery when the removal of the affected area is the only option to deal with the infection. Still, this option is chosen in urgent or untreatable cases only.

Patient Education

To predict bursitis or take emergency actions, patients have to be educated about this disorder. Firstly, it is important to know about the causes and risk factors of bursitis. Injuries, untreated infections, and other comorbidity diseases may result in the development of this musculoskeletal problem. Secondly, the awareness of lifestyle changes cannot be ignored, promoting taking rest, avoiding unhealthy environments and conditions, or using ice. Wearing protecting gears helps to reduce traumas and the level of injury.

Follow-Up

After the patient with bursitis is treated, it is still necessary to remember about follow-ups and control of the physical condition. A therapist usually appoints the next meeting in three-four days in case bursitis was caused by bacteria and in one week if it happened because of trauma. In addition to a general medicine doctor, cooperation with a rheumatologist or an orthopedic surgeon can be required, depending on the level of injury and the type of bursitis.

Evaluation and Conclusion

In general, bursitis is a frequent but treatable disease with its clinical characteristics and follow-ups. It does not take much time to reduce the level of pain, but patients have to remember that positive outcomes are achieved when they follow prescriptions and recommendations. The absence of evident symptoms, good imaging/lab test results, and no problems with movement are the major criteria for evaluation of bursitis treatment. There are many bursae in the body, and it is hard to control and predict the inflammation in each sac. Still, cooperation with doctors and the identification of the signs at their initial stages are characterized by positive health outcomes and the possibility to deal with acute, episodic, or chronic bursitis.

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References

Institute for Quality and Efficiency in Health Care. (2018). Bursitis: Overview. Web.

Ruangchaijatuporn, T., Gaetke-Udager, K., Jacobson, J. A., Yablon, C. M., & Morag, Y. (2017). Ultrasound evaluation of bursae: Anatomy and pathological appearances. Skeletal Radiology, 46(4), 445–462. Web.

Williams, C. H., & Sternard, B. T. (2019). Bursitis. Web.

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