American Board of Internal Medicine (ABIM) Certification Practice Exam

What guideline should be applied for the management of pain in patients with olecranon bursitis?

1. Administration of antibiotics

2. Injection of corticosteroids

3. Physical protection and use of NSAIDs

4. Rest and elevation only

The correct answer is: Physical protection and use of NSAIDs

The management of pain in patients with olecranon bursitis primarily focuses on conservative treatment, which often includes physical protection and the use of non-steroidal anti-inflammatory drugs (NSAIDs). This approach addresses the inflammation and pain associated with the condition effectively. Physical protection involves minimizing movement of the elbow, which can help reduce irritation and allow the bursa to heal. NSAIDs help manage pain and reduce inflammation in the affected area, making them a suitable choice in this context, as they provide symptomatic relief and decrease swelling. While the other options have their uses in different situations, they are not the first-line approach for managing uncomplicated olecranon bursitis. For example, antibiotics would only be indicated if there are signs of infection. Injectable corticosteroids can be used in specific circumstances when conservative measures are insufficient, but they are typically not initiated as the primary step in management. Rest and elevation alone can aid healing but may not fully address the pain and inflammation. Therefore, the combination of physical protection and NSAIDs provides a more comprehensive management strategy for this condition.