Busitis/Tendonitis/Synovitis

Bursitis, tenosynovitis, and synovitis are inflammatory conditions that can cause pain, swelling, and reduced mobility. Each condition has its unique characteristics and can be caused by various factors, including injury, repetitive motion, or underlying systemic diseases. 

Bursitis

  • Definition: Bursitis is the inflammation of a bursa, a small fluid-filled sac that acts as a cushion between bones and soft tissues (muscles, tendons, and skin) in the joints.
  • Causes: Can be caused by repetitive motion or pressure, trauma, infection, or systemic inflammatory conditions like rheumatoid arthritis.
  • Symptoms: Include pain, swelling, and tenderness in the affected area, particularly with movement or pressure.
  • Common Locations: Often occurs
    • in the shoulder (subacromial bursitis),
    • elbow (olecranon bursitis),
    • hip (trochanteric bursitis), and
    • knee (prepatellar bursitis).
  • Treatment: Resting the affected joint, applying ice, using non-steroidal anti-inflammatory drugs (NSAIDs), and physical therapy. In some cases, corticosteroid injections or surgery may be necessary.

Tenosynovitis

  • Definition: Tenosynovitis is the inflammation of the synovial sheath surrounding a tendon. The synovial sheath lubricates the tendon to reduce friction during movement.
  • Causes: Repetitive use, injury, infection, or inflammatory diseases can lead to tenosynovitis.
  • Symptoms: Pain, swelling, and difficulty moving the affected joint. In some cases, a creaking noise or feeling (crepitus) can be felt when moving the tendon.
  • Common Types:
    • De Quervain’s tenosynovitis (affecting the wrist) and
    • Trigger finger are well-known forms.
  • Treatment: Rest, splinting the affected joint, NSAIDs, and corticosteroid injections. Severe cases may require surgical intervention.

Synovitis

  • Definition: Synovitis refers to the inflammation of the synovial membrane, which lines the joints and produces synovial fluid for lubrication.
  • Causes: Can be triggered by trauma, overuse, autoimmune conditions like rheumatoid arthritis, or infection.
  • Symptoms: Joint pain, swelling, and stiffness, often worsening after periods of inactivity or in the morning.
  • Diagnosis: May involve physical examination, blood tests, imaging (like MRI or ultrasound), and joint fluid analysis.
  • Treatment: Involves managing the underlying cause, if identified. Treatments may include NSAIDs, corticosteroid injections, disease-modifying anti-rheumatic drugs (DMARDs) in autoimmune cases, and physical therapy.

Conclusion

  • Overlap and Distinction: While these conditions may present similarly, they affect different structures within or around the joints. Accurate diagnosis is crucial for effective treatment.
  • Chronicity and Management: These conditions can become chronic if not properly managed. A multidisciplinary approach involving medication, lifestyle modification, and possibly surgery is often required.
  • Prevention: Preventative strategies include proper ergonomics during activities, regular exercise, maintaining a healthy weight, and avoiding repetitive strain.

In all these conditions, early diagnosis and treatment are essential to prevent long-term joint damage and preserve joint function.