Abstracts
BCP Crystal Deposition
BCP Crystal Deposition
Basic "calcium" "phosphate" (BCP) crystals refer to a family of crystals including partially carbonate substituted "hydroxyapatite", octacalcium phosphate, and tricalcium phosphate. These crystals have been found in and around "joints" and have been associated with several forms of "arthritis" and periarthritis.
Periarthropathies associated with BCP crystals include calcific "tendinitis" and "bursitis".
Intra-articular BCP crystal deposition is common in "osteoarthritis", often found together with calcium pyrophosphate dihydrate crystals. Uncommon conditions in which BCP crystals are found include destructive shoulder arthropathies, acute "inflammatory" attacks of arthritis, and erosive arthritis.
Secondary deposition of BCP crystals has been observed in chronic "renal failure", in patients with ""collagen" vascular" diseases, following neurologic injury and after local corticosteroid injection.
Halverson PB: Arthropathies associated with basic calcium phosphate crystals. Scanning Microsc, 1992 Sep, 6:3, 791-6; discussion 796-7.
Bursitis and Atopic Dermatitis
Bursitis and Atopic Dermatitis
Bursal fluid accumulations are not usually associated with "skin disease"; however, several cases have been observed in a large atopic "dermatitis" (AD) clinic.
The unusual pretibial bursal fluid accumulations in AD, along with multiple recurrences of olecranon bursitis during flares of dermatitis, suggest that the association may not be coincidental.
Nassif A et al .,Olecranon and pretibial bursitis in "atopic dermatitis": coincidence or association? [see comments]. J Am Acad Dermatol, 1994 May, 30:5 Pt 1, 737-42.
Bursitis and Scleroderma
Bursitis and Scleroderma
Three types of subcutaneous bursitis were encountered in patients with "scleroderma": dry bursitis characterized by a rub, sterile bursitis characterized by inflammatory effusions without crystals by polarizing microscopy, and "septic" (staphylococcal) subcutaneous bursitis.
Laganą A & Canoso JJ Subcutaneous bursitis in scleroderma. J Rheumatol, 1992 Oct, 19:10, 1586-90.
Ischial Bursitis
Ischial Bursitis
Septic "ischial" bursitis is described in 4 patients with "spinal cord" injury. In these patients a pre-existing ischial bursitis probably became secondarily "infected".
Rubayi S & Montgomerie JZ: Septic ischial bursitis in patients with spinal cord injury. Paraplegia, 1992 Mar, 30:3, 200-3.
Massage
Massage
Presents two cases of chronic bursitis of the hip and shoulder treated by transverse friction massage. While clinical evidence has substantiated the benefits of friction massage on chronic tendinitis, previous literature has discouraged the use of friction massage in chronic bursitis. A functional examination and attention to associated biomechanical faults are also necessary for a complete noninvasive manual resolution of the problem.
Hammer WI The use of transverse friction massage in the management of chronic bursitis of the hip or shoulder. J Manipulative Physiol Ther, 1993 Feb, 16:2, 107-11.
Multiple Bursitis
Multiple Bursitis
Bursitis is a common clinical entity usually induced by trauma and "infection". It often occurs in inflammatory diseases such as "gout" and "rheumatoid arthritis". We describe a patient with systemic sclerosis who developed multiple bursitis in the later stage of the disease.
Ishikawa O et al., Multiple bursitis in systemic sclerosis. J Rheumatol, 1997 Jun, 24:6, 1189-90.
Occupation-Related Syndromes
Occupation-Related Syndromes
Physiologically, peripheral "nerve" entrapments show focal slowing, and histologically, segmental demyelination and remyelination occur. Entrapment neuropathies result from direct mechanical injury (e.g. chronic low pressure or friction in the "carpal tunnel syndrome"). Compartment syndromes occur when locally increased pressure within a closed "muscle" compartment compromises local "circulation" and neuromuscular function. Perioperative nerve "lesions" result from acute trauma to susceptible individual nerves during surgical procedures. Overuse syndromes belong to the broad clinical group of repetitive "strain" disorders, and are injuries caused by cumulative effects on tissues of repetitive physical "stress" that exceeds physiologic limits (e.g. occupation-related focal nerve compressions in certain musicians). Current utilization of neurophysiologic electrodiagnostic studies and neuroimaging technology, such as magnetic resonance imaging, facilitates diagnosis and appropriate therapy in many of the disorders mentioned in this paper.
Nakano KK: Peripheral nerve entrapments, repetitive strain disorder, occupation-related syndromes, bursitis, and "tendonitis". Curr Opin Rheumatol, 1991 Apr, 3:2, 226-39.
Prepatellar Bursitis
Prepatellar Bursitis
A patient had no history of gout and persistently normal "serum" "uric acid" concentrations but empiric "antibiotic" therapy failed. Urate crystals were detected when the prepatellar "bursa" was aspirated for the 3rd time, and the diagnosis was changed to gouty bursitis.
The case illustrates the importance of repeatedly aspirating suspicious sites to establish the diagnosis in elusive cases of crystal deposition disease.
Dawn B et al., Prepatellar bursitis: a unique presentation of tophaceous gout in an normouricemic patient. J Rheumatol, 1997 May, 24:5, 976-8.
Soft Tissue Rheumatism
Soft Tissue "Rheumatism"
"Pain" and stiffness of the injured region after prolonged periods of inactivity is commonly encountered following soft tissue injuries in sports. The injury in most of these instances is due to stress failure although occasionally an acute injury with a protracted course in recovery may develop similar symptoms.
The most common of these condition are the enthesopathies, that include tendonitis and fasciitis, "sprains" and "strains", bursitis, tenovaginitis and the "fibrositis" syndrome.
Satku K & Kumar VP: Soft tissue "rheumatism" in sports. Singapore Med J, 1992 Apr, 33:2, 193-4.
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