Rule Out Gout in the Workup of Olecranon Bursitis

Since gout can precipitate olecranon bursitis, should I routinely order a crystal analysis for patients who present with this bursitis?
-MD

The differential diagnosis of acute olecranon bursitis includes infectionand crystal-induced disease. The key test to order is culture and sensitivity;however, a crystal analysis is also important. I would order bothtests for patients who present with acute olecranon bursitis becausegout and infection can coexist. The most common organism found inthis setting is Staphylococcus aureus.

If aspiration is not possible, empiric antibiotic therapy for staphylococcalbursitis with careful follow-up is a reasonable management strategy.
-Michael H. Weisman, MD
  Director, Division of Rheumatology
  Cedars-Sinai Medical Center
  Los Angeles
  Professor of Medicine
  University of California, Los Angeles