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Olecranon Bursa Aspiration

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1. Olecranon Bursa Aspiration

Olecranon Bursa Aspiration Olecranon Bursa Aspiration Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Olecranon Bursa Aspiration (...) Olecranon Bursa Aspiration Aka: Olecranon Bursa Aspiration , Olecranon Bursa Injection II. Indications: Refractory to Conservative Measures (aspiration only) III. Aspiration of bursa fluid (Posterolateral triangle) Avoid if possible Risk of infection Risk of fistula formation Technique Patient supine with elbow flexed Mark area of maximal fluctuance for skin entry Aspirate with 22 gauge 1 inch needle Drain fluid Apply pressure dressing after aspiration IV. Corticosteroid Injection Indication: Refractory

2018 FP Notebook

2. Aspiration for the Treatment of Pre-patellar and Olecranon Bursitis: Clinical Evidence and Safety

/1201/p2097.html PubMed: PM12484691 5. Shell D, Perkins R, Cosgarea A. Septic olecranon bursitis: recognition and treatment. J Am Board Fam Pract. 1995 May;8(3):217-20. PubMed: PM7618500 6. Gross AE, Langer F. Aspiration and injection of joints, tendons and bursae. Can Fam Physician [Internet]. 1975 Sep [cited 2012 Oct 5];21(9):84-91. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2274686 PubMed: PM20469234 Additional References 7. McFarland EG, Mamanee P, Queale WS, Cosgarea AJ (...) Aspiration for the Treatment of Pre-patellar and Olecranon Bursitis: Clinical Evidence and Safety Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid

2012 Canadian Agency for Drugs and Technologies in Health - Rapid Review

3. Olecranon Bursa Aspiration

Olecranon Bursa Aspiration Olecranon Bursa Aspiration Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Olecranon Bursa Aspiration (...) Olecranon Bursa Aspiration Aka: Olecranon Bursa Aspiration , Olecranon Bursa Injection II. Indications: Refractory to Conservative Measures (aspiration only) III. Aspiration of bursa fluid (Posterolateral triangle) Avoid if possible Risk of infection Risk of fistula formation Technique Patient supine with elbow flexed Mark area of maximal fluctuance for skin entry Aspirate with 22 gauge 1 inch needle Drain fluid Apply pressure dressing after aspiration IV. Corticosteroid Injection Indication: Refractory

2015 FP Notebook

4. Innocuousness of office-based olecranon bursa aspiration (PubMed)

Innocuousness of office-based olecranon bursa aspiration 21642715 2016 04 22 2018 12 01 1715-5258 57 2 2011 Feb Canadian family physician Medecin de famille canadien Can Fam Physician Innocuousness of office-based olecranon bursa aspiration. 169 Lim Su-Chong SC eng Journal Article Canada Can Fam Physician 0120300 0008-350X IM Bursa, Synovial Bursitis Elbow Joint Humans Olecranon Process 2011 6 7 6 0 2011 6 7 6 0 2016 4 23 6 0 ppublish 21642715 57/2/169 PMC3038806 Can Fam Physician. 2010 Nov;56

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2011 Canadian Family Physician

5. Olecranon bursitis

(for example due to systemic illness) [ ; ]. Factors predisposing to septic bursitis include trauma to the elbow (including minor or repeated trauma), pre-existing bursal disease, prior aspiration and infiltration of the bursa, and impaired immunity (for example due to systemic corticosteroid treatment, diabetes, HIV, or alcohol abuse) [ ; ; ]. Prevalence How common is it? The overall incidence of olecranon bursitis in primary care is uncertain [ ; ], as most data is derived from hospital studies, which (...) Medical Journal Best practice review on bursitis [ ]. The treatment of septic bursitis requires needle aspiration for diagnosis and can guide antibiotic treatment once cultures are known [ ]. Although needle aspiration of the bursa is commonly performed for suspected septic olecranon bursitis and may be used as a definitive diagnostic test to differentiate septic from non-septic bursitis, it is not known whether the benefits of aspiration outweigh the possible drawbacks in the setting of non-septic

2016 NICE Clinical Knowledge Summaries

6. Olecranon Bursitis Caused by Candida parapsilosis in a Patient with Rheumatoid Arthritis (PubMed)

Olecranon Bursitis Caused by Candida parapsilosis in a Patient with Rheumatoid Arthritis Septic bursitis is usually caused by bacterial organisms. However, infectious bursitis caused by fungi is very rare. Herein, we present a 68-year-old woman with long-standing rheumatoid arthritis who developed pain, erythema, and swelling of the right olecranon bursa. Aspiration of the olecranon bursa showed a white blood cell count of 3.1 × 10(3)/μL (41% neutrophils, 30% lymphocytes, and 29% monocytes (...) ). Fluid culture was positive for Candida parapsilosis. She was treated with caspofungin 50 mg intravenously daily for 13 days followed by fluconazole 200 mg orally daily for one week. She responded well to this treatment but had recurrent swelling of the bursa. Bursectomy was recommended but she declined this option. This case, together with other reports, suggests that the awareness of uncommon pathogens, their presentation, and predisposing risk factors are important to establish an early diagnosis

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2016 Case reports in rheumatology

7. Chronic Olecranon Bursitis

Chronic Olecranon Bursitis Aka: Chronic Olecranon Bursitis From Related Chapters II. Mechanism Olecranon bursa overlies olecranon process Chronic results in inflammatory reaction III. Symptoms and Signs Thickened and y bursa Non-painful Multiple small, hard s on palpation Villous thickenings of bursa IV. Management Aspiration usually not helpful Incision contraindicated (risk of infection) Surgery to excise bursa Indicated for chronic bursa pain V. Prognosis Bursa usually dries up spontaneously VI (...) Chronic Olecranon Bursitis Chronic Olecranon Bursitis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Chronic Olecranon Bursitis

2018 FP Notebook

8. Swelling of olecranon bursa in uremic patients receiving hemodialysis. (PubMed)

Swelling of olecranon bursa in uremic patients receiving hemodialysis. Three patients with chronic renal failure who received therapy with hemodialysis through arteriovenous fistulas in the forearm had fluctuating swelling over the elbow on the same side as the fistula used for the dialysis. The clinical findings in each case were compatible with olecranon bursitis with effusion. The aspirate obtained from the swellings contained lymphocytes, polymorphonuclear leukocytes and histiocytes (...) , a finding similar to that in cases of uremic pericardial and pleural effusion. Biopsy of the bursa in one case showed hyalinized collagenous tissue with infiltration by histiocytes and lymphocytes, reflecting underlying chronic inflammation. Uremia was believed to be the causative factor. Bursitis with effusion is considered to be one of the clinical aspects of uremic polyserositis.

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1978 Canadian Medical Association Journal

9. Olecranon Bursitis (Overview)

to the presence of fever, redness, previous puncture wounds, or cellulitis), the olecranon bursa should be aspirated and the fluid sent for culture, for a cell count (white blood cells [WBCs], red blood cells [RBCs]), and for immediate Gram staining for bacteria. Tests should also be run for rheumatoid factor, the erythrocyte sedimentation rate, and the C-reactive protein level, in order to assess for rheumatoid arthritis. The uric acid level should be checked in order to assess for gout. [ ] Plain (...) olecranon bursa aspiration/injection usually does not require fluoroscopy or contrast, employing fluoroscopy here has demonstrated the outline of the involved bursa. Image ©2005, by Patrick M. Foye, MD, UMDNJ: New Jersey Medical School. Needle aspiration in olecranon bursitis. Image courtesy of UMDNJ-New Jersey Medical School, www.DoctorFoye.com, and www.TailboneDoctor.com. Aspiration of a hemorrhagic effusion in a patient with olecranon bursitis. Image courtesy of UMDNJ-New Jersey Medical School

2014 eMedicine.com

10. Olecranon Bursitis (Overview)

to the presence of fever, redness, previous puncture wounds, or cellulitis), the olecranon bursa should be aspirated and the fluid sent for culture, for a cell count (white blood cells [WBCs], red blood cells [RBCs]), and for immediate Gram staining for bacteria. Tests should also be run for rheumatoid factor, the erythrocyte sedimentation rate, and the C-reactive protein level, in order to assess for rheumatoid arthritis. The uric acid level should be checked in order to assess for gout. [ ] Plain (...) olecranon bursa aspiration/injection usually does not require fluoroscopy or contrast, employing fluoroscopy here has demonstrated the outline of the involved bursa. Image ©2005, by Patrick M. Foye, MD, UMDNJ: New Jersey Medical School. Needle aspiration in olecranon bursitis. Image courtesy of UMDNJ-New Jersey Medical School, www.DoctorFoye.com, and www.TailboneDoctor.com. Aspiration of a hemorrhagic effusion in a patient with olecranon bursitis. Image courtesy of UMDNJ-New Jersey Medical School

2014 eMedicine.com

11. Olecranon Bursitis (Treatment)

== processing > Olecranon Bursitis Treatment & Management Updated: Oct 04, 2018 Author: J Michael Wieting, DO, MEd, FAOCPMR, FAAPMR; Chief Editor: Stephen Kishner, MD, MHA Share Email Print Feedback Close Sections Sections Olecranon Bursitis Treatment Approach Considerations The patient’s physical condition and history should be taken into account when administering treatment for olecranon bursitis, as in the following cases: Pregnant patient - Aspiration of the bursa and corticosteroid injection can (...) , compared with 9 out of 64 in the two-stage group. [ ] Prevention A compressive elbow sleeve (eg, a neoprene or elastic sleeve) may help to prevent the bursal fluid from reaccumulating after aspiration, but the application of excessive pressure over the elbow should be avoided. Avoiding further trauma to the olecranon bursa is the key to recovery and prevention of recurrence. Consider use of elbow pads to cushion the elbow. For cases of olecranon bursitis in which there is repeated recurrence, consider

2014 eMedicine.com

12. Olecranon Bursitis (Treatment)

== processing > Olecranon Bursitis Treatment & Management Updated: Oct 04, 2018 Author: J Michael Wieting, DO, MEd, FAOCPMR, FAAPMR; Chief Editor: Stephen Kishner, MD, MHA Share Email Print Feedback Close Sections Sections Olecranon Bursitis Treatment Approach Considerations The patient’s physical condition and history should be taken into account when administering treatment for olecranon bursitis, as in the following cases: Pregnant patient - Aspiration of the bursa and corticosteroid injection can (...) , compared with 9 out of 64 in the two-stage group. [ ] Prevention A compressive elbow sleeve (eg, a neoprene or elastic sleeve) may help to prevent the bursal fluid from reaccumulating after aspiration, but the application of excessive pressure over the elbow should be avoided. Avoiding further trauma to the olecranon bursa is the key to recovery and prevention of recurrence. Consider use of elbow pads to cushion the elbow. For cases of olecranon bursitis in which there is repeated recurrence, consider

2014 eMedicine.com

13. Olecranon Bursitis (Follow-up)

== processing > Olecranon Bursitis Treatment & Management Updated: Oct 04, 2018 Author: J Michael Wieting, DO, MEd, FAOCPMR, FAAPMR; Chief Editor: Stephen Kishner, MD, MHA Share Email Print Feedback Close Sections Sections Olecranon Bursitis Treatment Approach Considerations The patient’s physical condition and history should be taken into account when administering treatment for olecranon bursitis, as in the following cases: Pregnant patient - Aspiration of the bursa and corticosteroid injection can (...) , compared with 9 out of 64 in the two-stage group. [ ] Prevention A compressive elbow sleeve (eg, a neoprene or elastic sleeve) may help to prevent the bursal fluid from reaccumulating after aspiration, but the application of excessive pressure over the elbow should be avoided. Avoiding further trauma to the olecranon bursa is the key to recovery and prevention of recurrence. Consider use of elbow pads to cushion the elbow. For cases of olecranon bursitis in which there is repeated recurrence, consider

2014 eMedicine.com

14. Olecranon Bursitis (Follow-up)

== processing > Olecranon Bursitis Treatment & Management Updated: Oct 04, 2018 Author: J Michael Wieting, DO, MEd, FAOCPMR, FAAPMR; Chief Editor: Stephen Kishner, MD, MHA Share Email Print Feedback Close Sections Sections Olecranon Bursitis Treatment Approach Considerations The patient’s physical condition and history should be taken into account when administering treatment for olecranon bursitis, as in the following cases: Pregnant patient - Aspiration of the bursa and corticosteroid injection can (...) , compared with 9 out of 64 in the two-stage group. [ ] Prevention A compressive elbow sleeve (eg, a neoprene or elastic sleeve) may help to prevent the bursal fluid from reaccumulating after aspiration, but the application of excessive pressure over the elbow should be avoided. Avoiding further trauma to the olecranon bursa is the key to recovery and prevention of recurrence. Consider use of elbow pads to cushion the elbow. For cases of olecranon bursitis in which there is repeated recurrence, consider

2014 eMedicine.com

15. Olecranon Bursitis (Diagnosis)

to the presence of fever, redness, previous puncture wounds, or cellulitis), the olecranon bursa should be aspirated and the fluid sent for culture, for a cell count (white blood cells [WBCs], red blood cells [RBCs]), and for immediate Gram staining for bacteria. Tests should also be run for rheumatoid factor, the erythrocyte sedimentation rate, and the C-reactive protein level, in order to assess for rheumatoid arthritis. The uric acid level should be checked in order to assess for gout. [ ] Plain (...) olecranon bursa aspiration/injection usually does not require fluoroscopy or contrast, employing fluoroscopy here has demonstrated the outline of the involved bursa. Image ©2005, by Patrick M. Foye, MD, UMDNJ: New Jersey Medical School. Needle aspiration in olecranon bursitis. Image courtesy of UMDNJ-New Jersey Medical School, www.DoctorFoye.com, and www.TailboneDoctor.com. Aspiration of a hemorrhagic effusion in a patient with olecranon bursitis. Image courtesy of UMDNJ-New Jersey Medical School

2014 eMedicine.com

16. Olecranon Bursitis (Diagnosis)

to the presence of fever, redness, previous puncture wounds, or cellulitis), the olecranon bursa should be aspirated and the fluid sent for culture, for a cell count (white blood cells [WBCs], red blood cells [RBCs]), and for immediate Gram staining for bacteria. Tests should also be run for rheumatoid factor, the erythrocyte sedimentation rate, and the C-reactive protein level, in order to assess for rheumatoid arthritis. The uric acid level should be checked in order to assess for gout. [ ] Plain (...) olecranon bursa aspiration/injection usually does not require fluoroscopy or contrast, employing fluoroscopy here has demonstrated the outline of the involved bursa. Image ©2005, by Patrick M. Foye, MD, UMDNJ: New Jersey Medical School. Needle aspiration in olecranon bursitis. Image courtesy of UMDNJ-New Jersey Medical School, www.DoctorFoye.com, and www.TailboneDoctor.com. Aspiration of a hemorrhagic effusion in a patient with olecranon bursitis. Image courtesy of UMDNJ-New Jersey Medical School

2014 eMedicine.com

17. Chronic Olecranon Bursitis

Chronic Olecranon Bursitis Aka: Chronic Olecranon Bursitis From Related Chapters II. Mechanism Olecranon bursa overlies olecranon process Chronic results in inflammatory reaction III. Symptoms and Signs Thickened and y bursa Non-painful Multiple small, hard s on palpation Villous thickenings of bursa IV. Management Aspiration usually not helpful Incision contraindicated (risk of infection) Surgery to excise bursa Indicated for chronic bursa pain V. Prognosis Bursa usually dries up spontaneously VI (...) Chronic Olecranon Bursitis Chronic Olecranon Bursitis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Chronic Olecranon Bursitis

2015 FP Notebook

18. Bursitis

) or superficial (e.g., the olecranon bursa). In bursitis there is thickening and proliferation of the synovial lining, bursal adhesions, villus formation, tags, and deposition of chalky deposits. This may result from repetitive stress, infection, autoimmune disease, or trauma. Key diagnostic findings are localised pain and tenderness over a bursa and swelling if superficially sited. Treatment for non-septic bursitis involves modified physical activity, rest, and analgesia. Corticosteroid injections (...) are reserved for those cases that do not respond to conservative management. Bursal excision is a last resort. The first-line treatment for a septic bursitis is aspiration and antibiotic therapy. Surgical debridement and lavage may be required. Definition Bursitis is an acute or chronic inflammatory condition of a bursa. A bursa is a jelly-like sac that usually contains a small amount of synovial fluid. A bursa lies between a tendon and either bone or skin to act as a friction buffer and facilitate

2018 BMJ Best Practice

19. A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiology

results, including ensuring that specimens arrive at the laboratory for analysis as quickly as possible after collection ( ). Table 1. Transport Issues (General Guide) a Specimen Type Specimen Required Collection Device, Temperature, and Ideal Transport Time Aerobic bacterial culture Tissue, fluid, aspirate, biopsy, etc Sterile container, RT, immediately Swab (second choice); flocked swabs are recommended Swab transport device, RT, 2 h Aerobic and anaerobic bacterial culture Tissue, fluid, aspirate (...) , biopsy, etc Sterile anaerobic container, RT, immediately Swab (second choice); flocked swabs are effective Anaerobic swab transport device, RT, 2 h Fungus culture; AFB culture Tissue, fluid, aspirate, biopsy, etc Sterile container, RT, 2 h Swab (second choice) (for yeast and superficial mycobacterial infections only) Swab transport device, RT, 2 h Virus culture Tissue, fluid, aspirate, biopsy, etc Viral transport media, on ice, immediately Swab; flocked swabs are recommended Virus swab transport

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2018 Infectious Diseases Society of America

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