II. Indication
- Suspected Septic Bursitis
- Standard of care recommendation
III. Background
- Rising MRSA rate dictates culture-directed therapy
IV. Technique
- Needle: 18-20 gauge
- Approach from lateral or distal aspect
V. Complications
- Benefit of aspirate findings outweighs risk
- Draining sinus development: 6%
- Sinuses develop at site other than aspiration site
- Implies that sinuses were unrelated to aspiration
- Stell (1999) J R Soc Med 92:516 [PubMed]
VI. Labs for aspirated fluid
- Bursal fluid culture
- Bursal fluid Gram Stain
- Bursal fluid crystal analysis
- Bursal fluid cell count with differential
- WBC >2000 cells/mm3 suggest septic bursa
- WBC <1500 cells/mm3 suggest non-infected bursa
VII. References
- Koutouzis (2006) Marx: Rosen's Emergency Med