• Bursae are synovial fluid-filled sacs found in areas subject to musculoskeletal friction, such as when tendons pass over bony prominences.
  • Although there are at least 78 different sites where bursae are found, the most common sites of clinical bursitis are the following:
    • Subdeltoid/subacromial
    • Olecranon (“student’s elbow”)
    • Prepatellar (“housemaid’s knee”)
    • Infrapatellar (“clergyman’s knee”)
    • Trochanteric
    • Radiohumeral
    • Ischial (“weaver’s bottom”)
    • Pes anserinus
    • Retrocalcaneal
  • Bursae serve a lubricating function, allowing for musculotendinous units to glide over bony prominences.
  • Bursae are lined with synovial membrane and play a role in synovial fluid mechanics.
  • System(s) affected: musculoskeletal

Pediatric Considerations
Bursitis is less common in children.


Predominant age

  • 15 to 50 years (most common in skeletally mature)
  • Traumatic bursitis is more likely in patients <35 years of age.


  • Bursitis: 32/1,000 per year
  • Approximately 1 in 31; 3.2% or 8.7 million people in the United States impacted annually.
  • Trochanteric pain: 1.8/1,000 per year

Etiology and Pathophysiology

  • Trauma: acute or chronic
  • Repetitive movement: Upper extremity bursitis, in particular, is usually the result of repetitive microtrauma.
  • Infections: transcutaneous transit > hematogenous, most commonly Staphylococcus aureus
  • Systemic disease: rheumatoid disease, tuberculosis, pancreatitis, lupus
  • Crystal deposition: gout and pseudogout

Risk Factors

  • Individuals who engage in repetitive motion and/or vigorous training
  • Prolonged pressure on particular bursae (e.g., “clergyman’s knee” and “student’s elbow”)
  • Sudden increase in level of activity
  • Leg length discrepancy and Trendelenburg gait increase risk for trochanteric bursitis.
  • Anabolic steroid use increases risk of bursitis due to increased training, estrogen suppression causing increased inflammation, and muscle stiffness.

General Prevention

  • Appropriate warm-up and cool-down maneuvers
  • Frequent breaks between repetitive activities
  • Use of protective gear (e.g., knee and elbow pads)
  • Maintain fitness and general health.

Commonly Associated Conditions

  • Tendinitis
  • Sprains, strains
  • Associated stress fractures
  • Muscular tightness and physical deconditioning

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