The patient is supine with the elbow flexed to 90 degrees and the forearm lying over the chest. Ethyl chloride or a comparable agent is applied to the skin for anesthesia. A 1.5 inch (3.75 cm), 16-gauge needle is inserted distally at the base of the bursa, nearly parallel to the ulna. 0.5 mL of lidocaine is injected subcutaneously prior to aspiration of bursal fluid.