BURSA

plural Bursas, or Bursae, any small pouch or sac within the mammalian body between tendons, muscles, or skin and bony prominences, at points of friction or stress. The bursas are classified by type as adventitious, subcutaneous, or synovial. Adventitious, or accidental, bursas arise in soft tissues as a result of repeated subjections to unusual shearing stresses, particularly over bony prominences. Subcutaneous bursas ordinarily are ill-defined clefts at the junction of subcutaneous tissue and deep fasciae (sheets of fibrous tissue); these bursas acquire a distinct wall only when they become abnormal, and they are classified as adventitious by some authorities. Synovial bursas are thin-walled sacs that are interposed between tissues such as tendons, muscles, and bones and are lined with synovial membrane, so called because it exudes synovia, a lubricating fluid. In the human body a majority of synovial bursas are located near the large joints of the arms and legs. A bunion is an adventitious bursa that develops on the inner side of the base of the great toe in association with hallux valgus (deviation of the first toe so that it lies on top of or below the other toes). Wearing narrow, pointed shoes is a major contributory factor. Mild cases are relieved by use of proper shoes and care of the feet, but surgery may be necessary for correction of severe deformities. Any type of inflammation of the bursas is called bursitis. The cause of most cases of bursitis appears to be one or another local mechanical irritation, although bursas may also be involved along with the joints and tendon sheaths in rheumatoid arthritis and gout. Diseases of the bursa also occur in domestic animals. Capped elbow and capped hock are examples of chronic bursitis in horses, resulting from lying on hard floors.