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Septic bursitis — MCCQE Part 1 MCQ

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ModerateJoint PainSeptic bursitisMCCQE Part 1

59-year-old carpenter presents with painful swollen elbow. Olecranon bursa is warm and erythematous; he has fever. Which of the following is the most appropriate next step?

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Correct answer: C — Aspirate if safe and treat with antibiotics, considering drainage

Aspirate if safe and treat with antibiotics, considering drainage is best because fever and inflamed bursa suggest septic bursitis. Treat with topical therapy only despite systemic or red-flag features is suboptimal because local treatment alone is inadequate when systemic disease is possible; Delay assessment for several months is suboptimal because red-flag musculoskeletal or dermatologic presentations require timely assessment; Use antibiotics for every presentation is suboptimal because many rashes and painful joints are inflammatory, malignant or mechanical rather than bacterial; Provide opioids or reassurance as the sole management is suboptimal because symptom relief alone does not address diagnosis, function or safety. Distinguish septic bursitis from gout and cellulitis.

Reference: AMMI Canada SSTI guidance