Common. Remember to check a BM in all patients to help exclude
Beware the immunocompromised patient. Primary bursitis
may originate from rheumatoid arthritis, gout or infections. Secondary bursitis
may arise from inflamed nearby structures (e.g. subacromial bursitis from
rotator cuff tendonitis)
Request help from ED duty doc if needed
If grossly infected, treat like an abscess - incise and drain.
Send sample in blood culture bottle and copy results of culture to GP.
If pus aspirate refer orthopaedics on-call
If unsure of infection
Send minimum 1ml of fluid in a "FBC" bottle for
white cell analysis.
High neutrophil count probably indicates infection (BMJ
article) for which a course of Flucloxacillin
Send sample in blood culture bottles and copy result to
Advise rest, give Ibuprofen and refer to the GP for