Confusable diagnoses · PANCE / PANRE

Septic Arthritis vs Bursitis

Septic Arthritis and Bursitis are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.

Septic Arthritis vs Bursitis at a glance

  • Septic Arthritis: Bacterial infection of a joint — orthopedic emergency requiring urgent arthrocentesis and drainage.
  • Bursitis: Inflammation of a synovial bursa from repetitive pressure, trauma, crystal disease, or infection.
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Side-by-side comparison

FeatureSeptic ArthritisBursitis
At a glanceBacterial infection of a joint — orthopedic emergency requiring urgent arthrocentesis and drainage.Inflammation of a synovial bursa from repetitive pressure, trauma, crystal disease, or infection.
Classic presentationAcute monoarticular pain, swelling, warmth, erythema; Markedly reduced range of motion; Fever, chills (variable — fever absent in up to 40%); Migratory…Olecranon bursitis classically produces a goose-egg over the posterior elbow with full elbow flexion and extension — the hallmark feature that distinguishes…
Workup / key labsArthrocentesis BEFORE antibiotics when possible (do not delay antibiotics if patient septic):; • WBC count, differential (typically >50,000 with >75% PMNs;…Aspirate fluctuant superficial bursae when infection is suspected: send fluid for Gram stain, culture, cell count with differential, and crystal analysis.…
ImagingPlain radiographs — baseline; usually unremarkable acutely; soft tissue swelling, joint effusion; Ultrasound — guides aspiration, especially for deep joints…Clinical diagnosis in most cases; imaging not routinely required; Plain radiographs if trauma, foreign body, or chronic refractory symptoms (look for…
First-line treatmentActivity modification, padding, and avoidance of direct pressure; Ice and NSAIDs — ibuprofen, naproxen, or diclofenac for 7-14 days; Compressive wrap for…

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Educational use only. This outline is a study aid for PA students and is not medical advice or a substitute for clinical judgment. FirstPassPA is an independent study tool and is not affiliated with, endorsed by, or sponsored by NCCPA. PANCE® and PANRE® are registered trademarks of the National Commission on Certification of Physician Assistants.