Olecranon bursitis
Updates to Article Attributes
Olecranon bursitis refers to inflammation of the olecranon bursa. The olecranon bursa is a subcutaneous sac that overlies the olecranon process and contains a small amount of fluid to prevent against injury of subcutaneous tissue and skin from the uncovered bony olecranon.
Clinical presentation
The presentation is with a tender, fluid-filled olecronon bursa. In cases associated with infection, there may also be overlying inflammatory skin changes (e.g. erythema) and systemic symptoms (e.g. fever) 4.
Pathology
Aetiology
Bursitis can develop secondary to many causes:
- excessive use - e.g.
student"student's elbow" - trauma
- acute trauma
- repetitive trauma
- infection - septic
- inflammation - rheumatoid arthritis, gouty arthropathy and CPPD
Radiographic features
Plain film
Lateral radiograph of the elbow reveals soft tissue swelling superficial to the olecranon4. TraumaticAn olecranon spur may also be visible 4. Clue to the underlying aetiology may also be present, such as traumatic fracture or calcification in gout or CPPD may be evident. Calcification in gout or CPPD4.
Ultrasound
May show a fluid collection in the olecranon bursa, features of synovial proliferation and/or hyperaemia. A small proportion of patients may also show presence of an associated loose body or features of associated triceps tendonitis (+/- calcifications) 2.
CT
- fluid density at the subcutaneous tissue superficial to the elbow
MRI
Bursal fluid collection has the following features:
- T1: hypointense
- T2: mainly hyperintense
- C+ (Gd): enhancement of bursal margins
Triceps brachii muscle and subcutaneous oedema as well as elbow joint effusion may be seen.
Treatment and prognosis
Olecranon bursitis is generally managed conservatively with supportive treatments such as resting, intermittent icing, compression, and simple analgesics (e.g. paracetamol, NSAIDs) 4. Aspiration of the bursal fluid is generally not required and carries risks (e.g. infection, sinus tract creation), and should be reserved if there is a suspicion of an unusual aetiology such as underlying infection 4. Surgical bursectomy is a treatment of last resort in cases refractory to the aforementioned treatments 4.
Generally, the condition is self-limiting over weeks and there are generally no chronic sequelae if managed conservatively 4.
-<p><strong>Olecranon bursitis</strong> refers to inflammation of the <a href="/articles/olecranon-bursa">olecranon bursa</a>. The olecranon bursa is a subcutaneous sac that overlies the olecranon process and contains a small amount of fluid to prevent against injury of subcutaneous tissue and skin from the uncovered bony olecranon.</p><h4>Pathology</h4><h5>Aetiology</h5><p>Bursitis can develop secondary to many causes:</p><ul>-<li>excessive use - e.g. student's elbow</li>- +<p><strong>Olecranon bursitis</strong> refers to inflammation of the <a href="/articles/olecranon-bursa">olecranon bursa</a>. The olecranon bursa is a subcutaneous sac that overlies the olecranon process and contains a small amount of fluid to prevent against injury of subcutaneous tissue and skin from the uncovered bony olecranon.</p><h4>Clinical presentation</h4><p>The presentation is with a tender, fluid-filled olecronon bursa. In cases associated with infection, there may also be overlying inflammatory skin changes (e.g. erythema) and systemic symptoms (e.g. fever) <sup>4</sup>.</p><h4>Pathology</h4><h5>Aetiology</h5><p>Bursitis can develop secondary to many causes:</p><ul>
- +<li>excessive use - e.g. "student's elbow"</li>
-</ul><h4>Radiographic features</h4><h5>Plain film</h5><p>Lateral radiograph of the <a href="/articles/elbow">elbow</a> reveals soft tissue swelling superficial to the olecranon. Traumatic fracture or calcification in gout or CPPD may be evident. Calcification in gout or CPPD.</p><h5>Ultrasound</h5><p>May show a fluid collection in the olecranon bursa, features of synovial proliferation and/or hyperaemia. A small proportion of patients may also show presence of an associated loose body or features of associated triceps tendonitis (+/- calcifications) <sup>2</sup>.</p><h5>CT</h5><ul><li>fluid density at the subcutaneous tissue superficial to the elbow</li></ul><h5>MRI</h5><p>Bursal fluid collection has the following features:</p><ul>- +</ul><h4>Radiographic features</h4><h5>Plain film</h5><p>Lateral radiograph of the <a href="/articles/elbow">elbow</a> reveals soft tissue swelling superficial to the olecranon <sup>4</sup>. An olecranon spur may also be visible <sup>4</sup>. Clue to the underlying aetiology may also be present, such as traumatic fracture or calcification in gout or CPPD <sup>4</sup>.</p><h5>Ultrasound</h5><p>May show a fluid collection in the olecranon bursa, features of synovial proliferation and/or hyperaemia. A small proportion of patients may also show presence of an associated loose body or features of associated triceps tendonitis (+/- calcifications) <sup>2</sup>.</p><h5>CT</h5><ul><li>fluid density at the subcutaneous tissue superficial to the elbow</li></ul><h5>MRI</h5><p>Bursal fluid collection has the following features:</p><ul>
-</ul><p><a href="/articles/triceps-brachii-muscle-1">Triceps brachii muscle</a> and subcutaneous oedema as well as <a href="/articles/elbow-joint-effusion">elbow joint effusion</a> may be seen.</p>- +</ul><p><a href="/articles/triceps-brachii-muscle-1">Triceps brachii muscle</a> and subcutaneous oedema as well as <a href="/articles/elbow-joint-effusion">elbow joint effusion</a> may be seen.</p><h4>Treatment and prognosis</h4><p>Olecranon bursitis is generally managed conservatively with supportive treatments such as resting, intermittent icing, compression, and simple analgesics (e.g. paracetamol, NSAIDs) <sup>4</sup>. Aspiration of the bursal fluid is generally not required and carries risks (e.g. infection, sinus tract creation), and should be reserved if there is a suspicion of an unusual aetiology such as underlying infection <sup>4</sup>. Surgical bursectomy is a treatment of last resort in cases refractory to the aforementioned treatments <sup>4</sup>.</p><p>Generally, the condition is self-limiting over weeks and there are generally no chronic sequelae if managed conservatively <sup>4</sup>.</p>
References changed:
- 4. Nchinda N & Wolf J. Clinical Management of Olecranon Bursitis: A Review. J Hand Surg Am. 2021;46(6):501-6. <a href="https://doi.org/10.1016/j.jhsa.2021.02.006">doi:10.1016/j.jhsa.2021.02.006</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/33840568">Pubmed</a>
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