Olecranon Bursitis

Are you worried about your swollen and tender elbow? Can you feel small lump beneath the elbow skin? It is quite likely that the bursa near the elbow joint is infected and you may be suffering from Olecranon bursitis. Get complete information about this disorder, including its causes, symptoms, diagnosis and treatment options.

What is Olecranon Bursitis?

It is a medical condition where the olecranon bursa at the tip of the elbow joint is affected and is characterized by inflammation, pain along with swelling. In this form of bursitis, the soft tissues glide over the bones and it becomes difficult for the patient to move the elbow freely. This swelling can give rise to various other problems in the elbow region.

Olecranon Bursitis ICD9 Code

The ICD9 code for Bursitis Olecranon is 726.33

Olecranon Bursitis Synonyms

Elbow Olecranon Bursitis is also known by various other names, such as:

Picture of Olecranon Bursitis

Picture 1 - Olecranon Bursitis

  • Baker’s elbow
  • Water on the elbow
  • Student’s elbow
  • Swellbow

Olecranon Bursitis Incidence

The exact prevalence of the disorder is not known. According to Canadian medical survey reports of 118 cases, however, the problem occurs in 10 out of every 100000 people. Reports suggest that septic and chronic forms are uncommon and people are more susceptible to non-septic Olecranon bursitis.

Olecranon Bursitis Causes

Infected or elbow Olecranon Bursitis can arise due to a number of mechanisms. Since the Olecranon Bursa is located at the exterior of the elbow, it is more prone to inflammation caused due to recurrent or acute trauma. Bursitis Olecranon is less commonly caused due to infection. Other reasons which can give rise to elbow bursitis include:

Prolonged pressure

Inclining on the elbow tip for a long period on a hard platform (like tabletop) can give rise to swelling of the bursa. It usually takes several months for bursitis olecranon to develop. Those who put pressure on their knees and lean on their elbows every day are more prone to the syndrome. Such people include air conditioning technicians, plumbers, heating technicians etc.

Medical conditions

A few specific ailments namely gout and rheumatoid arthritis, are related with elbow Olecranon Bursitis.

Trauma

Any hard blow or strike to the elbow tip can give rise to accumulation of excess fluid in the bursa and cause the joint to swell.

Infection

If an injury of the elbow tip such as a scrape, punctured wound or insect bite breaks and enters the skin, it might affect the bursa sac and give rise to infected Olecranon Bursitis. Such injury infects the bursa and causes swelling, inflammation, pain and production of excess fluid. Unless treated on time, the infection may lead to an accumulation of pus. In rare cases, the sac of the bursa gets infected even without any form of wound or injury.

Olecranon Bursitis Contributing Factors

There are a number of factors that predispose individuals to get affected with the disorder. Such factors need to be analyzed and verified by a physiotherapist. Some of the factors include:

  • Excessive physical training
  • Stiffness of the elbow joint
  • Insufficient treatment of the prior elbow injury
  • Tightness of the muscles.

Olecranon Bursitis Symptoms

This form of bursitis is more common among sportsmen. Acute injury at the tip of the elbow displays rapid warning signs. However, chronic bursitis takes several weeks to develop.

Swelling over the elbow tip serves as the primary symptom of the disorder. Such swelling can be moderate, mild or severe. An inflamed elbow tip often looks like a golf or tennis ball depending on the intensity of the disorder. Although an inflamed bursa is not painful, increased pressure on the swelling can give rise to intense pain whenever a patient intends to extend or bend the elbow. Bursitis arising due to an infection of bursa is defined as Septic Olecranon Bursits. The characteristics of Septic form of the disease are distinct from its non-septic form and include warning signs like:

  • Localized heat
  • Fever
  • Limited range of motion
  • Swelling
  • Pain
  • Lethargy and unwillingness
  • Tenderness

Olecranon Bursitis Diagnosis

Doctors prefer to diagnose this form of bursitis on the basis of the medical background of patients. Diagnosis is conducted only after confirming the occurrence of symptoms. Patients may consult physiotherapists who are specialized in detecting bursitis disorders. Usually, a proper physical examination and analysis is enough to deal with Baker’s elbow disorders.

A few other medical tests used for detecting elbow Olecranon Bursitis include:

X-ray

This clinical procedure is recommended to determine whether the affected elbow has suffered a fracture after a fall or sudden injury.

Lab Tests

Such tests are conducted to determine the presence of infection in the bursa. The fluid is extracted from the bursa and sent to a lab for testing. Lab tests determine whether or not the bursa is infected and helps a consulting physician to recommend medicines accordingly.

Olecranon Bursitis Differential Diagnosis

The swelling associated with this disorder is generally distinct. However, the condition is clinically identical to a number of other conditions that include:

  • Septic arthritis
  • Cellulitis
  • Rheumatoid arthritis
  • Trauma
  • Gout

Olecranon Bursitis Treatment

The treatment of the disorder depends on its cause. Doctors may examine the bursitis and ask several questions to a patient in order to confirm the source of the disorder. According to medical studies and researches, the treatment options for the condition include:

Image of Olecranon Bursitis

Picture 2 - Olecranon Bursitis

Physiotherapy

Physiotherapists advise a number of structured exercises in order to cure patients of non-septic bursitis. Electric stimulation, along with Phonophoresis, is recommended to patients to minimize the inflammation and pain.

Surgical Treatment

Olecranon bursitis aspiration, along with corticosteroid instillation, is used for immediate relief from pain and inflammation. Corticosteroid instillation should be strictly avoided, if doctors suspect infection of the bursa. Such patients should be counseled on an early basis in order to avoid swelling, pain and any further contamination. A compressed elbow sleeve can restrict the accumulation of the bursal fluid. A few cases which do not respond to other treatment require Bursectomy. Surgery is generally recommended when the bursa is swollen and is limiting the daily activities. Olecranon bursitis surgery provides long lasting indicative respite to the patients.

Olecranon Bursitis Medicines

Depending on the microbiology test results, doctors recommend antibiotics for patients suffering from septic bursitis. When antibiotics are given before the exact type of the infection is known, penicillinase-resistant penicillin (like flucloxacillin) is recommended to patients. If a patient is allergic to penicillin, use of a cephalosporin such as cefuroxime is advised. If he/she is experiencing severe symptoms, parenteral route is recommended at the beginning. Non-steroidal anti-inflammatory drugs (NSAIDs), when given with corticosteroid injections, can heal non-septic bursitis and cure patients.

Olecranon Bursitis Recovery

Doctors recommend patients to put splint on their operated arm to guard the skin. Extended immobilization is not necessary for sufferers. Doctors recommend a few specific exercises to patients to enhance their range of motion. 3-4 weeks after surgery, doctors allow patients to use their operated elbow freely. In order to restrict re-injury, the affected elbow must be protected with elbow pads for the next few months.

Olecranon Bursitis Prognosis

The prognosis of the disorder is very good since patients react well to the treatments offered, unless there is any underlying infection. For non-septic bursitis, corticosteroid injection is generally considered effective.

Olecranon Bursitis Complications

If septic bursitis occurs late in the elbow tip or if the diagnosis of the syndrome is not confirmed, the disorder can give rise to Osteomyelitis and Septicaemia. In intractable cases, the disease can lead to constant pain and reduced elbow usage.

Olecranon bursitis Prevention

Patients are advised to avoid applying excessive pressure on the affected elbow. One should take special care not to disturb the elbow by rubbing it constantly or engaging in any form of contact sports.

 

Olecranon Bursitis is a common elbow disorder. Constant pressure to the elbow joint or a sudden injury can give rise to the syndrome. If you experience swelling or pain on your elbow joint, consult a healthcare provider immediately. It is essential to get proper treatment before the syndrome leads to severe complications.

References:

http://orthoinfo.aaos.org/topic.cfm?topic=a00028

http://www.patient.co.uk/doctor/Olecranon-Bursitis-Student’s-Elbow.htm

http://emedicine.medscape.com/article/97346-medication

http://www.orthogate.org/patient-education/elbow/olecranon-bursitis.html

By    Last updated December 22nd, 2012

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