Arthritis vs Bursitis
Bursitis and arthritis are two conditions that present as joint pain. Although the symptoms are similar, the two conditions are two entirely different things. The only reason for similar symptoms is the close proximity of the structures involved in these two conditions.
Bursitis
Bursitis is the inflammation of the bursae. Bursa is a fibrous sac filled with synovial fluid. There are bursae around almost all joints in the body. Bursae are limited by a strong fibrous cover and are lined by synovium. The fluid inside the bursa makes a thin film. Bursae provide protection against friction between muscles, tendons and bones. Bursae make the movements at joints much easier. These bursae can get inflamed following injury. Injury may be due to a powerful acute force or due to wear and tear. Small injuries inside the synovium release inflammatory mediators which trigger an acute inflammatory reaction. The bursae swell up with edema fluid.
Presenting features of bursitis are pain at joint, limited movements, and a well-defined swelling. In many cases, the complete joint is not inflamed. Most common sites of bursa inflammation are elbow, first tarso-metatarsal joint, heels and knees. Features of acute inflammation are always there. Redness, pain, swelling, heat and poor functionality are these key features.
Investigations include joint X-ray, ESR, CRP, rheumatoid factor, ANA, DsDNA, antiphospholipid antibodies, full blood count and renal function tests. Bursitis may not show overt changes in investigations and the joint X-rays are almost always normal. Rest, heat therapy, physiotherapy, analgesics and anti-inflammatory drugs are the usual modes of treatment for bursitis.
Arthritis
Arthritis is inflammation of a joint. There are many causes for joint inflammation. Osteoarthritis, rheumatoid arthritis, rheumatic fever, post traumatic, infective and lupus arthritis are some such important causes. Arthritis can be classified according to many factors. Erosive and non-erosive, reactive and non-reactive, infective and non-infective are a few such key factors. The commonest cause of joint pain is osteoarthritis. It is due to wear and tear; thus it is common in weight bearing joints. Rheumatoid arthritis is an inflammatory arthritis of unknown origin. It affects knees, ankles and small joints of hands and feet. It leads to characteristic deformities like swan neck, boutonnieres, Z thumb and ulnar deviation of fingers. Rheumatic fever involves major joints, and it is a flitting arthritis. Trauma and fractures involving the articular surfaces lead to acute arthritis as well as osteoarthritis. Reactive arthritis may accompany urethritis, conjunctivitis and respiratory infections. Ankylosing spondylitis may accompany aortic valve abnormalities and anterior uveitis. SLE also affects small joints of hands and feet.
Treatment of arthritis depends on the actual diagnosis.
What is the difference between Bursitis and Arthritis?
• Bursitis is isolated inflammation of a tendinous bursa located outside the joint between bones, muscles and tendons while arthritis is the inflammation of the joint proper.
• Bursitis may be due to infection and trauma while there are many causes of joint inflammation.