Septic bursitis - Revision history

Lukecbailey1: /* EvaluationLohr KM et al. Bursitis workup. eMedicine. NOV 2017. https://emedicine.medscape.com/article/2145588-workup#c8 */

2023-06-24T11:55:48Z

EvaluationLohr KM et al. Bursitis workup. eMedicine. NOV 2017. https://emedicine.medscape.com/article/2145588-workup#c8

← Older revision		Revision as of 11:55, 24 June 2023
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	*Procedure		*Procedure
	**Placed in flexed position, elbow and forearm rested on surface		**Placed in flexed position, elbow and forearm rested on surface
	**Prep and ~~drap~~		**Prep and drape
	**Plus/minus local anesthesia skin wheal		**Plus/minus local anesthesia skin wheal
	**Approach with 18-22 ga needle from posterior aspect of bursa, aspirate until bursa is flat		**Approach with 18-22 ga needle from posterior aspect of bursa, aspirate until bursa is flat

Avisiani: /* EvaluationLohr KM et al. Bursitis workup. eMedicine. NOV 2017. https://emedicine.medscape.com/article/2145588-workup#c8 */

2021-02-12T04:06:38Z

EvaluationLohr KM et al. Bursitis workup. eMedicine. NOV 2017. https://emedicine.medscape.com/article/2145588-workup#c8

← Older revision		Revision as of 04:06, 12 February 2021
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	**Cell counts > 5000 - 20,000/µL depending on source		**Cell counts > 5000 - 20,000/µL depending on source
	***Predominance of PMNs		***Predominance of PMNs
	***Cell counts < 2000/µL, with predominant mononuclear cells highly suggestive of nonseptic bursitis		***Cell counts < 2000/µL, with a predominant mononuclear cells highly suggestive of nonseptic bursitis
	**Gram stain and culture		**Gram stain and culture
	***Gram stain with variable levels of sensitivities		***Gram stain with variable levels of sensitivities

Hoxbox at 09:28, 26 June 2020

2020-06-26T09:28:15Z

← Older revision		Revision as of 09:28, 26 June 2020
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	*[[Bursitis]]		*[[Bursitis]]

			==External Links==
			*Septic Bursitis: ED Presentation, Evaluation, and Management on [http://www.emdocs.net/septic-bursitis-ed-presentation-evaluation-and-management/ emDocs.net]
	==References==		==References==
	<references/>		<references/>

ClaireLewis: /* References */

2019-10-18T17:04:06Z

References

← Older revision		Revision as of 17:04, 18 October 2019
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	[[Category:Orthopedics]]		[[Category:Orthopedics]]
			[[Category:ID]]

ClaireLewis at 17:03, 18 October 2019

2019-10-18T17:03:54Z

← Older revision		Revision as of 17:03, 18 October 2019
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	*Acute pain, tenderness, warmth, and erythema of affected bursa		*Acute pain, tenderness, warmth, and erythema of affected bursa
	**None of which is seen in aseptic bursitis		**None of which is seen in aseptic bursitis
	*Fever (<50%)		*[[Fever]] (<50%)

	==Differential Diagnosis==		==Differential Diagnosis==
	*[[Olecranon bursitis (nonseptic)]]		*[[Olecranon bursitis (nonseptic)]]
	*[[Prepatellar bursitis (nonseptic)]]		*[[Prepatellar bursitis (nonseptic)]]
			*[[Cellulitis]]
			*[[Septic arthritis]]

	==Evaluation<ref>Lohr KM et al. Bursitis workup. eMedicine. NOV 2017. https://emedicine.medscape.com/article/2145588-workup#c8</ref>==		==Evaluation<ref>Lohr KM et al. Bursitis workup. eMedicine. NOV 2017. https://emedicine.medscape.com/article/2145588-workup#c8</ref>==
	*Plain radiograph, CT, MRI usually not helpful		*Plain radiograph, CT, MRI usually not helpful
	*US may help guide procedures or help with diagnostic uncertainty		*[[Musculoskeletal ultrasound\|US]] may help guide procedures or help with diagnostic uncertainty
	*Bursal fluid aspiration		*Bursal fluid aspiration
	**Both diagnostic and therapeutic		**Both diagnostic and therapeutic
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	**Approach with 18-22 ga needle from posterior aspect of bursa, aspirate until bursa is flat		**Approach with 18-22 ga needle from posterior aspect of bursa, aspirate until bursa is flat
	**Compressing bursa to help with aspiration		**Compressing bursa to help with aspiration
	**[[~~Arthocentesis~~]] should be performed if joint involvement suspected		**[[Arthrocentesis]] should be performed if joint involvement suspected
	*Septic workup		*Septic workup
	**Cell counts > 5000 - 20,000/µL depending on source		**Cell counts > 5000 - 20,000/µL depending on source
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	*Consider admission for:		*Consider admission for:
	**Extensive purulent bursitis		**Extensive purulent bursitis
	**Extensive surrounding cellulitis		**Extensive surrounding [[cellulitis]]
	**Suspected joint involvement		**Suspected [[septic arthritis\|joint involvement]]
	**Immunocompromised		**Immunocompromised
	**Failure to respond to course of PO antibiotics		**Failure to respond to course of PO antibiotics

Kxl328: /* Disposition */

2018-10-13T18:16:36Z

Disposition

← Older revision		Revision as of 18:16, 13 October 2018
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	**Extensive surrounding cellulitis		**Extensive surrounding cellulitis
	**Suspected joint involvement		**Suspected joint involvement
	**~~Immunocompromise~~		**Immunocompromised
	**Failure to ~~resopnd~~ to course of PO antibiotics		**Failure to respond to course of PO antibiotics

	==See Also==		==See Also==

Kxl328: /* Evaluation */

2018-10-13T18:16:03Z

Evaluation

← Older revision		Revision as of 18:16, 13 October 2018
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	*[[Prepatellar bursitis (nonseptic)]]		*[[Prepatellar bursitis (nonseptic)]]

	==Evaluation==		==Evaluation<ref>Lohr KM et al. Bursitis workup. eMedicine. NOV 2017. https://emedicine.medscape.com/article/2145588-workup#c8</ref>==
			*Plain radiograph, CT, MRI usually not helpful
			*US may help guide procedures or help with diagnostic uncertainty
	*Bursal fluid aspiration		*Bursal fluid aspiration
	**Both diagnostic and therapeutic		**Both diagnostic and therapeutic
Line 21:		Line 23:
	**Approach with 18-22 ga needle from posterior aspect of bursa, aspirate until bursa is flat		**Approach with 18-22 ga needle from posterior aspect of bursa, aspirate until bursa is flat
	**Compressing bursa to help with aspiration		**Compressing bursa to help with aspiration
			**[[Arthocentesis]] should be performed if joint involvement suspected
			*Septic workup
			**Cell counts > 5000 - 20,000/µL depending on source
			***Predominance of PMNs
			***Cell counts < 2000/µL, with predominant mononuclear cells highly suggestive of nonseptic bursitis
			**Gram stain and culture
			***Gram stain with variable levels of sensitivities
			***Thus, high WBC count with negative gram stain should not exclude diagnosis
			**Elevated protein
			**Reduced glucose
			**Crystal analysis

	==Management==		==Management==

Kxl328: /* Evaluation */

2018-10-13T18:10:05Z

Evaluation

← Older revision		Revision as of 18:10, 13 October 2018
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	*Bursal fluid aspiration		*Bursal fluid aspiration
	**Both diagnostic and therapeutic		**Both diagnostic and therapeutic
			**Do not perform if there is evidence overlying cellulitis
	*Procedure		*Procedure
	**Placed in flexed position, elbow and forearm rested on surface		**Placed in flexed position, elbow and forearm rested on surface

Kxl328: /* Evaluation */

2018-10-13T18:09:24Z

Evaluation

← Older revision		Revision as of 18:09, 13 October 2018
Line 14:		Line 14:
	*Bursal fluid aspiration		*Bursal fluid aspiration
	**Both diagnostic and therapeutic		**Both diagnostic and therapeutic
			*Procedure
	**Placed in flexed position, elbow and forearm rested on surface		**Placed in flexed position, elbow and forearm rested on surface
	**Prep and drap		**Prep and drap

Kxl328: /* Evaluation */

2018-10-13T18:09:03Z

Evaluation

← Older revision		Revision as of 18:09, 13 October 2018
Line 14:		Line 14:
	*Bursal fluid aspiration		*Bursal fluid aspiration
	**Both diagnostic and therapeutic		**Both diagnostic and therapeutic
			**Placed in flexed position, elbow and forearm rested on surface
			**Prep and drap
			**Plus/minus local anesthesia skin wheal
			**Approach with 18-22 ga needle from posterior aspect of bursa, aspirate until bursa is flat
			**Compressing bursa to help with aspiration

	==Management==		==Management==