I. Indications: Refractory to Conservative Measures

II. Aspiration of bursa fluid (Posterolateral triangle)

  1. Avoid if possible
    1. Risk of infection
    2. Risk of fistula formation
  2. Technique
    1. Patient supine with elbow flexed
    2. Mark area of maximal fluctuance for skin entry
    3. Aspirate with 22 gauge 1 inch needle
    4. Drain fluid
    5. Apply pressure dressing after aspiration

III. Corticosteroid Injection

  1. Indication: Refractory to conservative measures
    1. Acute or chronic bursa inflammation
  2. Contraindications to Corticosteroid Injection
    1. Olecranon Bursa Infection
  3. Technique
    1. Always exclude Olecranon Bursa Infection first
    2. Use technique as under aspiration listed above
    3. Needle: 25 gauge, inch with 5 cc syringe
    4. Injection solution
      1. Lidocaine 1% 2 cc
      2. Corticosteroid options
        1. Methylprednisolone (40 mg/ml): 1 ml or
        2. Celestone Soluspan (3 mg/ml): 1 ml

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