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 injury of subcutaneous tissue and skin from the uncovered bony olecranon.
Clinical presentation
The presentation is with a tender, fluid-filled olecranon 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's elbow"
-
trauma
acute trauma
repetitive trauma
infection: septic
inflammation: rheumatoid arthritis, gouty arthropathy, and CPPD
Radiographic features
Plain radiograph
Lateral radiographs of the elbow reveal soft tissue swelling superficial to the olecranon 4. An olecranon spur may also be visible 4. A clue to the underlying aetiology may also be present, such as traumatic fracture or calcification in gout or CPPD 4.
Ultrasound
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 the presence of an associated loose body or features of associated triceps tendinopathy (+/- 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 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 olecranon 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>-<li>trauma<ul>-<li>acute trauma</li>-<li>repetitive trauma</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 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 olecranon 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><p>excessive use - e.g., "student's elbow"</p></li>
- +<li>
- +<p>trauma</p>
- +<ul>
- +<li><p>acute trauma</p></li>
- +<li><p>repetitive trauma</p></li>
-<li>infection: septic</li>-<li>inflammation: <a href="/articles/rheumatoid-arthritis">rheumatoid arthritis</a>, <a href="/articles/gout">gouty arthropathy</a> and <a href="/articles/calcium-pyrophosphate-dihydrate-deposition-disease-1">CPPD</a>-</li>-</ul><h4>Radiographic features</h4><h5>Plain radiograph</h5><p>Lateral radiographs of the <a href="/articles/elbow">elbow</a> reveal soft tissue swelling superficial to the olecranon <sup>4</sup>. An <a href="/articles/olecranon-spur">olecranon spur</a> may also be visible <sup>4</sup>. A 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>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 the presence of an associated loose body or features of associated <a href="/articles/triceps-tendinopathy">triceps tendinopathy</a> (+/- 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>-<li>-<strong>T1</strong>: hypointense</li>-<li>-<strong>T2</strong>: mainly hyperintense</li>-<li>-<strong>C+ (Gd)</strong>: enhancement of bursal margins</li>- +<li><p>infection: septic</p></li>
- +<li><p>inflammation: <a href="/articles/rheumatoid-arthritis">rheumatoid arthritis</a>, <a href="/articles/gout">gouty arthropathy</a>, and <a href="/articles/calcium-pyrophosphate-dihydrate-deposition-disease-1">CPPD</a></p></li>
- +</ul><h4>Radiographic features</h4><h5>Plain radiograph</h5><p>Lateral radiographs of the <a href="/articles/elbow">elbow</a> reveal soft tissue swelling superficial to the olecranon <sup>4</sup>. An <a href="/articles/olecranon-spur">olecranon spur</a> may also be visible <sup>4</sup>. A 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>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 the presence of an associated loose body or features of associated <a href="/articles/triceps-tendinopathy">triceps tendinopathy</a> (+/- calcifications) <sup>2</sup>.</p><h5>CT</h5><ul><li><p>fluid density at the subcutaneous tissue superficial to the elbow</p></li></ul><h5>MRI</h5><p>Bursal fluid collection has the following features:</p><ul>
- +<li><p><strong>T1</strong>: hypointense</p></li>
- +<li><p><strong>T2</strong>: mainly hyperintense</p></li>
- +<li><p><strong>C+ (Gd)</strong>: enhancement of bursal margins</p></li>
Image 14 Ultrasound (Long and short axis images) ( create )
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