Diagnosis of bursitis and tendinitis
How Are These Conditions Diagnosed?
Diagnosis of tendinitis and
bursitis begins with a medical history and physical examination. The
patient will describe the pain and circumstances in which pain occurs.
The location and onset of pain, whether it varies in severity throughout
the day, and the factors that relieve or aggravate the pain are all
important diagnostic clues.
Therapists and physicians will use manual
tests called selective tissue tension tests to determine which tendon is
involved, and then will palpate (a form of touching the tendon)
specific areas of the tendon to pinpoint the area of inflammation.
X
rays do not show tendons or bursae, but may be helpful in ruling out
problems in the bone or arthritis. In the case of a torn tendon, x rays
may help show which tendon is affected. In a knee injury, for example,
an x ray will show that the patella is lower than normal in a quadriceps
tendon tear and higher than normal in a patellar tendon tear.
The
doctor may also use magnetic resonance imaging (MRI) to confirm a
partial or total tear. MRIs detect both bone and soft tissues like
muscles, tendons and their coverings (sheaths), and bursae.
An anesthetic-injection
test is another way to confirm a diagnosis of tendinitis. A small amount
of anesthetic (lidocaine hydrochloride) is injected into the affected
area. If the pain is temporarily relieved, the diagnosis is confirmed.
To rule out infection, the doctor may remove and test fluid from the inflamed area.
