Question 1

A patient with elbow pain without localized erythema or warmth is diagnosed with bursitis of the elbow and serum laboratory results are pending. What is the initial treatment while waiting for these results?

A) Aspiration of the bursal sac for culture
B) Corticosteroid injection into the bursal sac
C) Elbow pads, NSAIDs, rest, and ice
D) Physical and occupational therapy

C

Accepted Answer

The initial treatment for bursitis of the elbow is typically conservative management with elbow pads, NSAIDs, rest, and ice. Aspiration of the bursal sac for culture may be necessary in cases where infection is suspected, but this is not the initial treatment. Corticosteroid injection may be used in some cases, but should not be the initial treatment without further assessment and consideration of potential risks and benefits. Physical and occupational therapy may be beneficial in the management of chronic or recurrent cases of bursitis, but is not the initial treatment.

Question 2

What are included in the initial management of bursitis of the heel? (Select all that apply.)&#10;A) Activity modification and bracing&#10;B) Closed heel shoes to prevent further injury&#10;C) Corticosteroid injections&#10;D) Nonsteroidal anti-inflammatory medications&#10;E) Rest, ice, compression, and elevation

Accepted Answer

The initial management of bursitis of the heel includes activity modification and bracing to prevent further injury, nonsteroidal anti-inflammatory medications for pain relief and reduction of inflammation, and rest, ice, compression, and elevation to alleviate symptoms. Corticosteroid injections may be recommended for severe cases but are not typically included in the initial management. Closed heel shoes may be recommended for comfort and support but are not necessary to prevent further injury.

Question 3

A patient experiencing shoulder pain is seen by an orthopedic specialist who notes erythema, warmth, and fluctuance of the shoulder joint. What is the next step in treatment for this patient?&#10;A) Admit to the hospital for intravenous antibiotics.&#10;B) Inject lidocaine into the joint and reassess in 5 to 10 minutes.&#10;C) Order a plain radiograph of the shoulder to identify possible fracture.&#10;D) Perform a shoulder ultrasound to further evaluate the cause.

Accepted Answer

The presence of erythema, warmth, and fluctuance suggest an infectious process such as septic arthritis. Admission to the hospital for intravenous antibiotics is the appropriate management. Injecting lidocaine or ordering radiographs or ultrasound are not appropriate initial steps in the management of suspected septic arthritis.

Deck 156: Bursitis