What's this big lump on my elbow? Olecranon Bursitis
What is Olecranon Bursitis?
Firstly you need to know what the Olecranon is and secondly
what Bursitis is and then it will make sense:
The Olecranon process is a bony prominence at the end of the
Ulna bone, basically it is the point of your elbow. Because of this, it is an
area of potential friction on internal structures running over it. In the body
where these potential friction areas exist there is usually a Bursa.
A Bursa is basically a fluid filled sac designed to reduce the friction between the bone and other soft tissues. So Olecranon Bursitis is basically inflammation of this exact Bursa.
A Bursa is basically a fluid filled sac designed to reduce the friction between the bone and other soft tissues. So Olecranon Bursitis is basically inflammation of this exact Bursa.
What causes Olecranon Bursitis?
There are two types of Olecranon Bursitis:
Non-septic — this is the most common type and is basically
inflammation resulting from various causes including trauma or overuse.
Septic — this type is less common and is basically an
infection in the bursa.
How common is Olecranon Bursitis?
It isn’t that common, I’ve seen it a handful of times in my
career. Buono et al (2012) found that it accounts for between 0.01% - 0.1% of
overall hospital admissions.
It affects young to middle-aged men the most. Generally jobs
which cause regular elbow trauma, load or pressure over the bursa.
It also affects athletes who play sports that involve
repetitive overhead throwing or elbow movement.
How do you diagnose Olecranon Bursitis?
The main sign of Olecranon Bursitis is swelling over the tip
of the elbow that appears over several hours to several days. The swelling can
increase and decrease and may be tender or warm.
Pain is caused by compression at end of range bending of the
elbow and sometimes when loading the triceps.
An MRI could be indicated to ascertain the presence of an
abscess or osteomyelitis, but most of the time it isn’t required (Buono et
al 2012).
How do you treat Olecranon Bursitis?
Most cases of Olecranon Bursitis resolve without
complications; however, recurrent episodes may occur especially after recurrent
minor trauma.
Management of non-septic bursitis includes:
Most people will respond to conservative treatment, which
usually involves rest, compression, avoidance of any aggravating movements of the
elbows, and painkillers until the symptoms improve.
Also as the triceps crosses the bursa then overuse and
shortening of this muscle can be relevant so light stretches may also be
beneficial.
Occasionally if the swelling is large then they may be need
to aspirate it with a needle.
If this fails then a corticosteroid injection into the bursa
may be considered.
If after 2 months conservative treatment isn’t working then
surgery is the next step.
The surgery is basically a complete removal of the inflamed bursa,
followed by a short period of immobilisation in an elbow pad to allow early recovery
of range of motion, and early strengthening and stretching exercises (Buono et
al 2012).
Management of septic bursitis includes:
Basically antibiotics are the treatment of choice. Initially
broad spectrum but a culture can be taken to work out the exacting antibiotic required.
Again like non-septic, you can consider aspiration to
improve function and comfort in the short term.
This type can be linked to other conditions so the
appropriate management of these is vital. Commonly they can be gout, cellulitis,
or rheumatoid arthritis.
Obviously infection can be very serious so if the septic
bursitis develops into extensive cellulitis or a severe infection resulting in
systemic toxicity, then you may need to be admitted to hospital.
Comments
Post a Comment