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[Section Outline]

Bursitis !!navigator!!

Inflammation of the thin-walled bursal sac surrounding tendons and muscles over bony prominences. The subacromial and greater trochanteric bursae are most commonly involved.

TREATMENT

Bursitis

Prevention of aggravating conditions, rest, NSAIDs, and local glucocorticoid injections.

Tendinitis !!navigator!!

May involve virtually any tendon but frequently affects tendons of the rotator cuff around shoulder, especially the supraspinatus. Pain is dull and aching but becomes acute and sharp when tendon is squeezed below acromion.

TREATMENT

Tendinitis

NSAIDs, glucocorticoid injection, and physical therapy may be beneficial. The rotator cuff tendons or biceps tendon may rupture acutely, frequently requiring surgical repair.

Calcific Tendinitis !!navigator!!

Results from deposition of calcium salts (primarily hydroxyapatite) in tendon, usually supraspinatus. The resulting pain may be sudden and severe.

TREATMENT

Calcific Tendinitis

Most are self-limited and respond to physical therapy, NSAIDs. Refractory disease treated with ultrasound-guided needle aspiration and lavage or surgery.

Adhesive Capsulitis (“frozen Shoulder”) !!navigator!!

Results from conditions that enforce prolonged immobility of shoulder joint. Shoulder is painful and tender to palpation, and both active and passive range of motion is restricted.

TREATMENT

Adhesive Capsulitis

Spontaneous improvement may occur; physical therapy is the foundation; NSAIDs, local injections of glucocorticoids may be helpful.

Outline

Section 12. Allergy, Clinical Immunology, and Rheumatology