Most cases of tendinitis and bursitis can be initially diagnosed by your family doctor who may refer you to a rheumatologist, a doctor who specializes in disorders of the joint. Before your appointment, write down a list of things you need to tell the doctor. Note any concerns or questions you may have. Also write down the names and dosages of any prescription, over-the-counter medications, or supplements you are taking.
To diagnose bursitis, your doctor or rheumalotogist will review your medical history and daily activities. If symptoms might be related to the use of a tool or sports equipment, the doctor might ask you to demonstrate movements. You will be asked to describe the pain, show where it occurs, discuss what times of day you experience pain, and describe what activities may bring it on or make it go away.
Usually, bursitis can be diagnosed clinically. Doctors conduct routine physical exams to check overall health, areas of pain and tenderness, and strength and range of motion. The exam may also include assessing nerve function (feeling and reflexes) and blood circulation (pulse). If your medical history and physical exam indicate bursitis, you will probably not need additional testing.
However, imaging tests such as ultrasound or MRI can help confirm a bursitis diagnosis when deep bursae are not readily accessible for inspection, palpation, or aspiration. These tests are done to confirm or exclude a suspected diagnosis. These imaging techniques increase the accuracy of identifying the involved structures. If you have a swollen bursa, however, fluid may need to be removed from the bursa (aspiration) to check for infection. If additional information is required, your doctor may request blood tests. Diagnostic tests for bursitis may include:
Arthrogram - An x-ray used to view bone structures following an injection of a contrast fluid into a joint area. If the fluid appears in an area that it shouldn’t, the leak would provide evidence of a tear, opening, or blockage, suggesting possible disease or injury.
Aspiration – This is a procedure that involves removal of fluid from the swollen bursa to exclude infection or gout as causes of bursitis.
Blood tests – Blood tests include routine laboratory tests performed to confirm or eliminate other conditions.
Computed tomography scan (CT scan) – A CT scan is a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays and can provide doctors with diagnostic images that confirm or exclude bursitis.
Magnetic resonance imaging (MRI) - This diagnostic procedure uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body and is helpful to identifying possible locations of bursa inflammation.
Ultrasound – During an ultrasound, high-frequency sound waves are used to create an image of the affected joint.
X-ray - This diagnostic test uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film.
Once diagnosed, bursitis can be treated. Bursitis that is not the result of an infection can generally be treated with rest, ice compresses, and anti-inflammatory and pain medications. Bursitis that is the result of an infection in the bursa requires further investigation and antibiotic therapy. But what other treatment options are available? Learn more about how to treat bursitis next.
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