Olecranon bursitis

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Olecranon bursitis
Other namesElbow bursitis, liquid elbow, elbow bump, student's elbow, Popeye elbow, baker's elbow, swellbow
Bursitis Elbow WC.JPG
Olecranon bursitis
Specialty Emergency medicine, orthopedics
Symptoms Swelling, redness, and pain at the tip of the elbow [1] [2]
TypesAcute, chronic, septic [2]
CausesTrauma, pressure, infection [1]
Risk factors Rheumatoid arthritis, gout [1]
Diagnostic method Based on symptoms [3]
Differential diagnosis Septic arthritis, tendinitis, cellulitis [4]
Prevention Elbow pads [2]
TreatmentAvoiding further trauma, compression bandage, NSAIDs, drainage, surgery [1] [2]
FrequencyRelatively common. [2]

Olecranon bursitis is a condition characterized by swelling, redness, and pain at the tip of the elbow. [1] [2] If the underlying cause is due to an infection, fever may be present. [2] The condition is relatively common and is one of the most frequent types of bursitis. [2]

Contents

It usually occurs as a result of trauma or pressure to the elbow, infection, or certain medical conditions such as rheumatoid arthritis or gout. [1] Olecranon bursitis is associated with certain types of work including plumbing, mining, gardening, and mechanics. [2] The underlying mechanism is inflammation of the fluid filled sac between the olecranon and skin. [2] Diagnosis is usually based on symptoms. [3]

Treatment involves avoiding further trauma, a compression bandage, and NSAIDs. [1] [2] If there is concern of infection the fluid should be drained and tested and antibiotics are typically recommended. [1] The use of steroid injections is controversial. [5] Surgery may be done if other measures are not effective. [1]

Signs and symptoms

Symptoms include swelling in the elbow, which can sometimes be large enough to restrict motion. There is pain originating in the elbow joint from mild to severe which can spread to the rest of the arm. If the bursa is infected, there also will be prominent redness and the skin will feel very warm. Another symptom would include the infected bursa possibly opening spontaneously and draining pus. [6]

Causes

Hard blow to the tip of the elbow on a wall Hard blow to the tip of the elbow.jpg
Hard blow to the tip of the elbow on a wall

Bursitis normally develops as a result either of a single injury to the elbow (for example, a hard blow to the tip of the elbow), or perhaps more commonly due to repeated minor injuries, such as repeated leaning on the point of the elbow on a hard surface. The chance of developing bursitis is higher if one's job or hobby involves a repetitive movement (for example, tennis, golf, or even repetitive computer work involving leaning on one's elbow). [7] The likelihood of developing the condition is increased as one gets older. [8]

As a reaction to injury, the lining of the bursa becomes inflamed. It then secretes a much greater than normal amount of fluid into the closed cavity of the bursa, from where it has nowhere to go. The bursa therefore inflates, producing a swelling over the proximal end of the ulna which is usually inflamed and tender.

Another possible cause of inflammation of the bursa is infection, which can usually (but not always) be traced to a crack or other lesion in the skin which allowed for bacteria of the normal skin flora to invade deeper layers of tissue. [6]

This bursa is located just over the extensor aspect of the extreme proximal end of the ulna. In common with other bursae, it is impalpable and contains only a very small amount of fluid in its normal state, and fulfills the function of facilitating the joint's movement by enabling anatomical structures to glide more easily over each other.

Diagnosis

Diagnosis is usually based on symptoms. [3] If there is concern of infection the fluid should be drained and tested. [1]

Treatments

Non-surgical

Conservative management of minor cases involves icing, a compression bandage, and avoidance of the aggravating activity. This can also be augmented with NSAIDs taken by mouth or applied as a cream. Elbow padding can also be used for symptomatic relief. The use of steroid injections is controversial. [5]

In case of infection, the bursitis should be drained and treated with an antibiotic. [6]

Surgery

If the fluid continues to return after multiple drainings or the bursa is constantly causing pain, surgery [9] to remove the bursa is an option. The minor operation removes the bursa from the elbow and is left to regrow but at a normal size over a period of ten to fourteen days. It is usually done under general anesthetic and has minimal risks. The surgery does not disturb any muscle, ligament, or joint structures. To recover from surgical removal, a splint will be applied to the arm to protect the skin. Exercises will be prescribed to improve range of motion. [6]

Related Research Articles

Tendinopathy

Tendinopathy, also known as tendinitis or tendonitis, is a type of tendon disorder that results in pain, swelling, and impaired function. The pain is typically worse with movement. It most commonly occurs around the shoulder, elbow, wrist, hip, knee, or ankle.

Tenosynovitis

Tenosynovitis is the inflammation of the fluid-filled sheath that surrounds a tendon, typically leading to joint pain, swelling, and stiffness. Tenosynovitis can be either infectious or noninfectious. Common clinical manifestations of noninfectious tenosynovitis include de Quervain tendinopathy and stenosing tenosynovitis

Shoulder problem

Shoulder problems including pain, are one of the more common reasons for physician visits for musculoskeletal symptoms. The shoulder is the most movable joint in the body. However, it is an unstable joint because of the range of motion allowed. This instability increases the likelihood of joint injury, often leading to a degenerative process in which tissues break down and no longer function well.

Pleurisy

Pleurisy, also known as pleuritis, is inflammation of the membranes that surround the lungs and line the chest cavity (pleurae). This can result in a sharp chest pain while breathing. Occasionally the pain may be a constant dull ache. Other symptoms may include shortness of breath, cough, fever or weight loss, depending on the underlying cause.

Laryngitis

Laryngitis is inflammation of the larynx. Symptoms often include a hoarse voice and may include fever, cough, pain in the front of the neck, and trouble swallowing. Typically, these last under two weeks.

Septic arthritis

Septic arthritis, also known as joint infection or infectious arthritis, is the invasion of a joint by an infectious agent resulting in joint inflammation. Symptoms typically include redness, heat and pain in a single joint associated with a decreased ability to move the joint. Onset is usually rapid. Other symptoms may include fever, weakness and headache. Occasionally, more than one joint may be involved.

Nasal polyp

Nasal polyps (NP) are noncancerous growths within the nose or sinuses. Symptoms include trouble breathing through the nose, loss of smell, decreased taste, post nasal drip, and a runny nose. The growths are sac-like, movable, and nontender, though face pain may occasionally occur. They typically occur in both nostrils in those who are affected. Complications may include sinusitis and broadening of the nose.

Bursitis Human disease

Bursitis is the inflammation of one or more bursae of synovial fluid in the body. They are lined with a synovial membrane that secretes a lubricating synovial fluid. There are more than 150 bursae in the human body. The bursae rest at the points where internal functionaries, such as muscles and tendons, slide across bone. Healthy bursae create a smooth, almost frictionless functional gliding surface making normal movement painless. When bursitis occurs, however, movement relying on the inflamed bursa becomes difficult and painful. Moreover, movement of tendons and muscles over the inflamed bursa aggravates its inflammation, perpetuating the problem. Muscle can also be stiffened.

Pericoronitis Inflammation of the soft tissues surrounding the crown of a partially erupted tooth

Pericoronitis is inflammation of the soft tissues surrounding the crown of a partially erupted tooth, including the gingiva (gums) and the dental follicle. The soft tissue covering a partially erupted tooth is known as an operculum, an area which can be difficult to access with normal oral hygiene methods. The hyponym operculitis technically refers to inflammation of the operculum alone.

Prepatellar bursitis Inflammation of the prepatellar bursa at the front of the knee

Prepatellar bursitis is an inflammation of the prepatellar bursa at the front of the knee. It is marked by swelling at the knee, which can be tender to the touch and which generally does not restrict the knee's range of motion. It can be extremely painful and disabling as long as the underlying condition persists.

Golfers elbow

Golfer's elbow, or medial epicondylitis, is tendinosis of the medial epicondyle on the inside of the elbow. It is in some ways similar to tennis elbow, which affects the outside at the lateral epicondyle.

Knee effusion

Knee effusion occurs when excess synovial fluid accumulates in or around the knee joint. It has many common causes, including arthritis, injury to the ligaments or meniscus, or fluid collecting in the bursa, a condition known as prepatellar bursitis.

Greater trochanteric pain syndrome (GTPS), is inflammation of the trochanteric bursa, a part of the hip.

Subacromial bursitis

Subacromial bursitis is a condition caused by inflammation of the bursa that separates the superior surface of the supraspinatus tendon from the overlying coraco-acromial ligament, acromion, and coracoid and from the deep surface of the deltoid muscle. The subacromial bursa helps the motion of the supraspinatus tendon of the rotator cuff in activities such as overhead work.

Ulnar nerve entrapment

Ulnar nerve entrapment is a condition where the ulnar nerve becomes physically trapped or pinched, resulting in pain, numbness, or weakness, primarily affecting the little finger and ring finger of the hand. Entrapment may occur at any point from the spine at cervical vertebra C7 to the wrist; the most common point of entrapment is in the elbow. Prevention is mostly through correct posture and avoiding repetitive or constant strain. Treatment is usually conservative, including medication, activity modification and exercise, but may sometimes include surgery. Prognosis is generally good, with mild to moderate symptoms often resolving spontaneously.

Elbow Joint between the upper and lower parts of the arm

The elbow is the visible joint between the upper and lower parts of the arm. It includes prominent landmarks such as the olecranon, the elbow pit, the lateral and medial epicondyles, and the elbow joint. The elbow joint is the synovial hinge joint between the humerus in the upper arm and the radius and ulna in the forearm which allows the forearm and hand to be moved towards and away from the body.

Hygroma (canine disease)

A hygroma, or a false bursa, is a discrete, fluid-filled sac that can form on the joints of dogs in response to repeated pressure, such as that from sitting on a hard surface. It is treated by draining the fluid and may be prevented by providing padded bedding.

The hand is a very complex organ with multiple joints, different types of ligament, tendons and nerves. Hand disease injuries are common in society and can result from excessive use, degenerative disorders or trauma.

Otitis externa

Otitis externa, also called swimmer's ear, is inflammation of the ear canal. It often presents with ear pain, swelling of the ear canal, and occasionally decreased hearing. Typically there is pain with movement of the outer ear. A high fever is typically not present except in severe cases.

Tornwaldt's disease is the inflammation or abscess of the embryonic cyst of pharyngeal bursa. It is located in the midline of the posterior wall of the nasopharynx. It is covered anteriorly by mucosa in the adenoid mass. It is bounded posteriorly by longus muscle.

References

  1. 1 2 3 4 5 6 7 8 9 10 "Elbow (Olecranon) Bursitis". AAOS. Retrieved 19 February 2018.
  2. 1 2 3 4 5 6 7 8 9 10 11 Reilly, D; Kamineni, S (January 2016). "Olecranon bursitis". Journal of Shoulder and Elbow Surgery. 25 (1): 158–67. doi:10.1016/j.jse.2015.08.032. PMID   26577126.
  3. 1 2 3 "Bursitis - Musculoskeletal and Connective Tissue Disorders". MSD Manual Professional Edition. Retrieved 19 February 2018.
  4. Ferri, Fred F. (2017). Ferri's Clinical Advisor 2018 E-Book: 5 Books in 1. Elsevier Health Sciences. p. 229. ISBN   9780323529570.
  5. 1 2 Sayegh, ET; Strauch, RJ (November 2014). "Treatment of olecranon bursitis: a systematic review". Archives of Orthopaedic and Trauma Surgery. 134 (11): 1517–36. doi:10.1007/s00402-014-2088-3. PMID   25234151. S2CID   11975578.
  6. 1 2 3 4 "Elbow (Olecranon) Bursitis -OrthoInfo - AAOS". Orthoinfo.aaos.org. 2011-01-01. Retrieved 2013-08-19.
  7. NHS direct - Bursitis
  8. Mayo Clinic - Bursitis risk factors
  9. eOrthopod - Olecranon Bursitis Surgery
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