Olecranon bursitis, also known as elbow bursitis, is a common condition that affects the bursa, a small fluid-filled sac located at the tip of the elbow. The bursa acts as a cushion between the bone and the skin, allowing for smooth movement of the joint. When the bursa becomes inflamed or irritated, it can lead to swelling, pain, and limited mobility of the elbow. In this blog, we will discuss the causes, clinical signs, imaging, treatment, and the importance of a medical assessment by a doctor for accurate diagnosis and treatment.
Causes of Olecranon Bursitis
There are several causes of olecranon bursitis:
Trauma: A direct blow or impact to the elbow may cause damage or irritation to the bursa, leading to inflammation and swelling.
Repetitive pressure or friction: Prolonged pressure on the elbow, such as leaning on hard surfaces, can cause irritation and inflammation of the bursa. This is common among individuals whose work or hobbies require them to rest their elbows on hard surfaces for extended periods.
Infection: A bacterial infection, often caused by a break in the skin near the elbow, can lead to an infected bursa. This is known as septic bursitis and requires prompt medical attention.
Medical conditions: Some systemic medical conditions, such as rheumatoid arthritis or gout, can cause inflammation in various joints, including the olecranon bursa.
Overuse: Activities that require repetitive elbow motions, such as throwing sports or manual labour, can lead to overuse injuries and bursitis.
Less commonly, olecranon bursitis can be idiopathic, which means it occurs without any known cause.
Clinical signs:
The most common symptom of olecranon bursitis is a visible swelling at the tip of the elbow. The swelling can range from mild to severe and may be tender to the touch. The skin over the affected area may be warm and red, and there may be a limited range of motion in the elbow joint. In some cases, the bursa may become infected, leading to the development of fever, chills, and redness spreading from the elbow.
Imaging:
Imaging studies such as X-rays, ultrasound, or MRI may be ordered to evaluate the extent of the injury or inflammation. X-rays can show bone spurs and rule out fractures or other structural bone abnormalities while ultrasound can assess the size and content of the bursa. MRI can evaluate the extent of inflammation or damage to surrounding structures.
The role of ultrasound in olecranon bursitis is multifaceted, providing valuable diagnostic, therapeutic, and monitoring benefits. As a non-invasive and cost-effective imaging modality, ultrasound allows healthcare providers to accurately diagnose bursitis by visualising the affected bursa and detecting fluid accumulation or thickening. It also helps in differentiating between septic and non-septic bursitis, which is crucial for determining appropriate treatment. Ultrasound assists in assessing the severity of inflammation and guiding therapeutic interventions, such as fluid aspiration and corticosteroid injections, ensuring precise needle placement and minimising complications. Furthermore, it enables clinicians to monitor the progress of treatment by evaluating changes in bursa size and fluid content, which can inform decisions on additional interventions or the effectiveness of the current treatment plan.
Treatment:
The treatment of olecranon bursitis depends on the severity of the symptoms and the underlying cause. In mild cases, self-care measures such as rest, ice, compression, and elevation of the affected area can help reduce swelling and pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can also help to reduce inflammation and pain. In more severe cases, your doctor may recommend aspiration of the bursa to remove excess fluid, and in some cases, a corticosteroid injection may be given to reduce inflammation.
In cases of infection, antibiotics may be prescribed. In some cases, surgical intervention may be required to remove the bursa if other treatments are unsuccessful or if the bursitis recurs.
Importance of medical assessment:
It is important to seek medical attention if you experience any symptoms of olecranon bursitis. Your doctor can perform a physical examination to evaluate the extent of swelling and tenderness, and may order imaging tests to determine the underlying cause of the bursitis. Proper diagnosis is essential to ensure that you receive the most effective treatment for your condition. In some cases, other conditions such as gout, rheumatoid arthritis, or cellulitis may present with similar symptoms, making an accurate diagnosis critical for proper treatment and management.
In conclusion, olecranon bursitis is a common condition that can cause swelling, pain, and limited mobility of the elbow joint. Self-care measures and medical treatments can help reduce symptoms and improve function. If you experience any symptoms of olecranon bursitis, it is important to seek medical attention to receive an accurate diagnosis and appropriate treatment.
About the Author: Dr. Mustafa Alnaib MBChB, MRCS, MSc, FEBOT is an orthopaedic surgeon, musculoskeletal doctor and Clinic Director at ACTIVATE Musculoskeletal Clinic in Kent.