Olecranon bursitis is an inflammation of the bursa over the elbow bone that can be caused by trauma, repetitive motion, or underlying conditions like gout or arthritis. Examination may reveal a tender or painful swelling over the elbow. Treatment depends on the cause but may include rest, ice, compression, aspirating fluid, antibiotics for infection, and surgery for severe cases not improving with conservative care.
Olecranon bursitis is an inflammation of the bursa over the elbow bone that can be caused by trauma, repetitive motion, or underlying conditions like gout or arthritis. Examination may reveal a tender or painful swelling over the elbow. Treatment depends on the cause but may include rest, ice, compression, aspirating fluid, antibiotics for infection, and surgery for severe cases not improving with conservative care.
Olecranon bursitis is an inflammation of the bursa over the elbow bone that can be caused by trauma, repetitive motion, or underlying conditions like gout or arthritis. Examination may reveal a tender or painful swelling over the elbow. Treatment depends on the cause but may include rest, ice, compression, aspirating fluid, antibiotics for infection, and surgery for severe cases not improving with conservative care.
bursa overlying the olecranon process between the bone and skin. Other synonyms for olecranon bursitis are student’s elbow, miner’s elbow and draftsman’s elbow. Aetiology
• The common causes of olecranon bursitis are
1. Post-traumatic – acute haemorrhagic bursitis due to direct trauma. 2. Chronic – repetitive rubbing on hard surfaces. 3. Inflammatory – gout, pseudo-gout, uraemia, rheumatoid arthritis, pigmented villonodular synovitis. 4. Infection – pyogenic, tuberculosis. Basic science and history • Olecranon bursitis is relatively common in adults but less so in children. • Normally, the bursa prevents soft-tissue tears by providing a mechanism for skin to glide freely over the olecranon process. • Direct trauma to the area in sports or from injury leads to acute swelling as the bursa fills up with blood and effusion . • There may be associated fractures of the olecranon spurs. • • It is important to rule out underlying fractures and ligament injuries in the differential diagnosis. • Chronic aseptic bursal swelling is the most common form of olecranon bursitis. • It occurs most commonly from repetitive rubbing of the olecranon on hard surfaces and is often asymptomatic. • Inflamed and infected olecranon bursitis is the most difficult to treat. • It is often difficult to differentiate septic from aseptic inflammatory arthritis and often needs microbiological confirmation EXAMINATION
• Acute post-traumatic bursitis may present as a
tender, fluctuant, fluid-filled swelling with aspiration yielding haemorrhagic fluid. • Patients with chronic, aseptic bursitis present with painless swelling overlying the olecranon process and often give a history of repetitive rubbing of the elbows on hard surfaces. • Patients with systemic conditions like rheumatoid arthritis, gout, uraemia and other medical conditions may present with painful swelling of the olecranon bursa(e). • Septic olecranon bursitis may be primary (haematogenous spread) or secondary to local cortisone injections. • Patients may have local signs of inflammation with or without discharging sinus, with some patients presenting with systemic signs of infection DIFFERENTIAL DIAGNOSIS
• The differential diagnosis of acute bursitis
includes : underlying fractures and ligamentous injuries. Rarely, a synovial cyst may mimic bursitis of the elbow IMAGING
• Radiographs are mandatory for post-traumatic
onset bursitis to rule out fracture. • Ultrasound studies may reveal an underlying abscess or fluid collection. • MRI may reveal underlying abscess or osteomyelitis not apparent in the radiographs. Treatment • Acute post-traumatic bursitis can be treated conservatively initially with rest, ice, a compression dressing, elevation and non-steroidal anti-inflammatory drugs (NSAIDs) to decrease swelling and pain. • Excessive swelling may need to be aspirated, • However, in patients not responding to conservative treatment for a long time, surgical bursectomy may be indicated. • Septic bursitis should be treated with aspiration, intravenous or oral antibiotics, rest, ice, compression, elevation and occasional splinting. • Incision and drainage may be needed if aspiration alone fails to control symptoms • Patients with chronic, aseptic bursitis of idiopathic aetiology or from repeated rubbing of the elbow can be given protective pads for elbows, ice, instructions regarding avoiding repetitive trauma, NSAIDs and reassurance. Aspiration and corticosteroid injection have been shown to result in more rapid recovery at 6 months than only NSAID treatment. • .