Tendinitis & Bursitis
Also known as: Tendonitis, Bursitis
Inflammation of tendons and bursae causing localized pain and limited motion. Diagnosed with ultrasound and treated with targeted injections and therapy.
Key Facts
- Among the most common reasons for rheumatology referral
- Can be simple overuse injuries or signs of inflammatory arthritis
- Ultrasound-guided injection is more accurate than landmark-based injection
- Often coexist — the same area may have both tendon and bursa inflammation
- Recurrence is common without addressing biomechanical causes
What are tendinitis and bursitis?
Tendinitis is inflammation or irritation of a tendon — the thick cords connecting muscle to bone. Bursitis is inflammation of a bursa — a small, fluid-filled sac that cushions bones, tendons, and muscles near joints. Both cause localized pain and limited range of motion, and they frequently occur together.
While tendinitis and bursitis can be simple overuse injuries, they also occur in the context of inflammatory conditions like rheumatoid arthritis, psoriatic arthritis, and gout. Determining whether the problem is mechanical or inflammatory changes the treatment approach entirely.
Common locations
- Shoulder — rotator cuff tendinitis, subacromial bursitis
- Elbow — lateral epicondylitis (tennis elbow), olecranon bursitis
- Hip — trochanteric bursitis, gluteal tendinopathy
- Knee — patellar tendinitis, prepatellar bursitis
- Wrist and hand — de Quervain’s tenosynovitis
- Ankle and foot — Achilles tendinitis, plantar fasciitis
Symptoms
- Localized pain and tenderness at the affected tendon or bursa
- Pain that worsens with specific movements
- Swelling at the affected area
- Limited range of motion
- Pain may radiate from the primary site
- Symptoms often worse at night or after activity
How we diagnose it
- Physical exam — Localized tenderness, pain with specific movements, swelling
- Musculoskeletal ultrasound — Dr. Fellows performs in-office ultrasound to directly visualize tendon thickening, tears, fluid in bursae, and calcifications. This confirms the diagnosis and reveals the extent of the problem — often more accurately than MRI for superficial tendons.
- Blood work — If inflammatory disease is suspected as the underlying cause
- Aspiration — If bursitis raises concern for infection or crystal disease (gout)
How we treat it
- Ultrasound-guided corticosteroid injections — Precise injection into the affected tendon sheath or bursa. Guidance is especially important for deep structures like hip bursae.
- Rest and activity modification — Reducing the repetitive motion causing irritation
- Physical therapy referral — Strengthening and stretching to prevent recurrence
- NSAIDs — Oral or topical anti-inflammatories for acute management
- Treatment of underlying cause — If tendinitis or bursitis is part of an inflammatory condition, treating the underlying disease is essential
At Synergy Rheumatology
Ultrasound is the ideal tool for evaluating tendinitis and bursitis — it shows the problem in real time and allows precise guided injection in the same visit. We also determine whether your tendon or bursa issue is mechanical or a sign of an underlying inflammatory condition that requires broader treatment.
Have questions about tendinitis & bursitis?
Schedule an appointment to discuss your symptoms, diagnosis, or treatment options with Dr. Fellows.