The Case: 
This 55 year old corporate executive with well controlled hypertension presents with swelling of the right elbow for about 3 weeks. Over this time he has “bumped” his elbow more than once and is having increased pain in the area. He denies any obvious cuts to the elbow, fevers or rashes. Upon arrival to the ED his vital signs are unremarkable. His examination is significant only for a boggy prominence over his right elbow apex which is slightly erythematous and tender to palpation. He grimaces when passive motion is attempted. The right elbow is slightly warmer than the left. There is no axillary lymphadenopathy and the rest of his joints appear normal as does the remainder of his physical examination.