Bursitis

Question 1

Olecranon bursitis

Answer 1

Inflammation and swelling of the bursa over the elbow

Above the ulnar bone

Question 2

Bursae

Answer 2

Sacs created by synovial membrane filled with a small amount of synovial fluid

Found at bony prominences

Act to reduce friction between the bones and soft tissue during movement

Question 3

Bursitis

Answer 3

Inflammation of a bursa

Causes thickening of the synovial membrane and increased fluid production causing swelling

Question 4

Causes of inflammation

Answer 4

Friction from repetitive movements or leaning on the elbow

Trauma

Inflammatory conditions (rheumatoid arthritis or gout)

Infection (Septic bursitis)

Question 5

Presentation

Answer 5

Swollen

Warm

Tender

Fluctuant

Question 6

Aspiration

Answer 6

Pus indicates infection

Straw-coloured indicates infection less likely

Blood-stained indicates trauma, infection or inflammatory cause

Milky indicates gout or pseudogout

Question 7

Management

Answer 7

Rest

Ice

Compression

Analgesia

Protect from pressure or trauma

Aspirate fluid to relieve pressure

Steroid injections in problematic cases where infection has been excluded

Question 8

Management if infection suspected

Answer 8

Aspiration of fluid for microscopy and culture

Antibiotics

Flucloxacillin first-line (clarythromycin as an alternative)

Question 9

Trochanteric bursitis presentation

Answer 9

Pain localised to outer hip (aching or burning)

Not usually any swelling