II. Indication

  1. Suspected Septic Bursitis
    1. Standard of care recommendation

III. Background

  1. Rising MRSA rate dictates culture-directed therapy

IV. Technique

  1. Needle: 18-20 gauge
  2. Approach from lateral or distal aspect

V. Complications

  1. Benefit of aspirate findings outweighs risk
  2. Draining sinus development: 6%
    1. Sinuses develop at site other than aspiration site
    2. Implies that sinuses were unrelated to aspiration
    3. Stell (1999) J R Soc Med 92:516 [PubMed] (or open in [QxMD Read])

VI. Labs for aspirated fluid

  1. Bursal fluid culture
  2. Bursal fluid Gram Stain
  3. Bursal fluid crystal analysis
  4. Bursal fluid cell count with differential
    1. WBC >2000 cells/mm3 suggest septic bursa
    2. WBC <1500 cells/mm3 suggest non-infected bursa

VII. References

  1. Koutouzis (2006) Marx: Rosen's Emergency Med

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