Olecranon and prepatellar bursitis: treating acute, chronic, and inflamed.

Elbow and knee bursitis is common in both athletes and nonathletes and has three basic presentations: acute, chronic nonseptic, and chronic infected. Most acute swellings occur after trauma and can be treated with early aspiration, compression, and padding. Chronic, nonseptic bursitis can usually be treated with conservative therapy and, occasionally, aspiration or corticosteroid injection. Inflamed bursae should be aggressively evaluated and treated. Some may require aspiration and decompression, and oral or intravenous antibiotics should be started to prevent septicemia. Incision and drainage is rarely needed but may be indicated for injuries that do not respond. Surgical excision of the bursa is recommended only for recalcitrant cases.