Bursae

Sandwiched between tissues that slide past each other, bursae decrease the frictional forces present. They are endothelial­lined cushions and normally contain little fluid. If they are overloaded they can become inflamed, swollen and very painful. Although the appearances can mimic sepsis, a pathogenic organism is rarely isolated in cases of closed injury. Common sites for bursitis to develop are:

  olecranon;

  psoas tendon;

  greater trochanter;

  iliotibial band;

  prepatellar;

  infrapatellar;

  retrocalcaneal.

Avoidance of the aggravating mechanical factors and a short course of anti-inflammatories is usually sufficient to control symptoms. Intractable cases require aspiration and steroid injections and, more rarely, excision of the indurated bursal wall.