Bursitis, Tendonitis, Fibromyalgia, and RSD Joe Lex, MD, FAAEM Temple University School of Medicine Philadelphia, PA joe@ Objectives Explain how bursitis and tendonitis are similar Explain how bursitis and tendonitis differ from from another List phases in development and healing of bursitis and tendonitis Objectives mon types of bursitis and tendonitis found at the: Shoulder Elbow Wrist 5. List indications / contraindications for injection therapy of bursitis and tendonitis Hip Knee Ankle Objectives Describe typical findings in a patient with fibromyalgia Describe typical findings in a patient with reflex sympathetic dystrophy Sports Society more athletic Physical activity health benefits Overuse syndromes increase 25% to 50% of participants will experience tendonitis or bursitis Intro Workplace Musculoskeletal disorders from… …repetitive motions …localized contact stress …awkward positions …vibrations …forceful exertions Ergonomic design incidence Intro Bursae Closed, round, flat sacs Lined by synovium May or may municate with synovial cavity Occur at areas of friction between skin and underlying ligaments / bone Intro Bursae Permit lubricated movement over areas of potential impingement Many are nameless ~78 on each side of body New bursae may form anywhere from frequent irritation Intro Bursitis Inflamed by… …chronic friction …trauma …crystal deposition …infection …systemic disease: rheumatoid arthritis, psoriatic arthritis, gout ankylosing spondylitis Intro Bursitis Inflammation causes bursal synovial cells to thicken Excess fluid accumulates inside and around affected bursae Intro