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Advanced Life Support in Obstetrics (ALSO®).Outpatient antibiotics may be considered in those who are not acutely ill patients who are acutely ill should be hospitalized and treated with intravenous antibiotics. For septic bursitis, antibiotics effective against Staphylococcus aureus are generally the initial treatment, with surgery reserved for bursitis not responsive to antibiotics or for recurrent cases. Chronic inflammatory bursitis (e.g., gout, rheumatoid arthritis) is treated by addressing the underlying condition, and intrabursal corticosteroid injections are often used. Although intrabursal corticosteroid injections are sometimes used to treat microtraumatic bursitis, high-quality evidence demonstrating any benefit is unavailable. Bursal aspiration of microtraumatic bursitis is generally not recommended because of the risk of iatrogenic septic bursitis. Chronic microtraumatic bursitis should be treated conservatively, and the underlying cause addressed. Acute traumatic/hemorrhagic bursitis is treated conservatively with ice, elevation, rest, and analgesics aspiration may shorten the duration of symptoms. Management depends on the type of bursitis. If infection is suspected, bursal aspiration should be performed and fluid examined using Gram stain, crystal analysis, glucose measurement, blood cell count, and culture. Blood testing (white blood cell count, inflammatory markers) and magnetic resonance imaging can help distinguish infectious from noninfectious causes. Ultrasonography can help distinguish bursitis from cellulitis. Diagnosis is usually based on clinical presentation, with a particular focus on signs of septic bursitis. Other causes include acute trauma/hemorrhage, inflammatory disorders such as gout or rheumatoid arthritis, and infection (septic bursitis).

Chronic microtrauma (e.g., kneeling on the prepatellar bursa) is the most common cause of superficial bursitis.

Less common locations are the superficial infrapatellar and subcutaneous (superficial) calcaneal bursae. Superficial bursitis most often occurs in the olecranon and prepatellar bursae.

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