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A Controlled, Blinded Prospective Trial

David L. Smith, MD; John H. McAfee, MD; Linda M. Lucas, MD; Kusum L. Kumar, MD; Doug M. Romney

Arch Intern Med. 1989;149(11):2527-2530.

Abstract
• We enrolled 42 patients with nonseptic olecranon bursitis in a double-blind prospective treatment trial to compare the efficacy of an intrabursal steroid preparation with that of an oral antiinflammatory agent. Patients were randomized into one of four treatment regimens: (1) methylprednisolone acetate (20 mg) intrabursal injection and oral naproxen (1 g/d for 10 days), (2) methylprednisolone acetate (20 mg) intrabursal injection and oral placebo for 10 days, (3) oral naproxen (1 g/d for 10 days), and (4) oral placebo for 10 days. The degree of swelling in millimeters was assessed at study introduction and at 1,3, and 6 weeks. At 6 months, the number of patients requiring reaspiration for bursitis recurrence was tabulated. Data at 1 week indicated that patients treated with an intrabursal methylprednisolone acetate injection (20 mg) demonstrated the most rapid decrease in swelling. At 6 weeks, the methylprednisolone-treated groups demonstrated sustained improvement. At 6 months, the mean number of reaspirations per patient for reaccumulation of bursal fluid was higher in groups 3 (1.0±1.2) and 4 (0.4 ± 0.7). An intrabursal methylprednisolone acetate 20-mg injection seems to be the most effective treatment regimen for nonseptic olecranon bursitis.

(Arch Intern Med. 1989;149:2527-2530)

Author Affiliations
From the Division of General Medicine, Department of Medicine, Oregon Health Sciences University, and Ambulatory Care and Medical Service, Section of Arthritis and Rheumatic Diseases, Veterans Administration Medical Center, Portland, Ore.

Footnotes
Accepted for publication June 23, 1989.

Reprints not available.

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