olecranon bursitis
Jump to navigation
Jump to search
Etiology
- traumatic
- inflammatory bursitis
- gout, pseudogout (CPPD)
- rheumatoid arthritis
- infection, especially in patients on hemodialysis
Pathology
Clinical manifestations
- posterior elbow warmth, redness & swelling[2]
- non-infectious olecranon bursitis presents as swelling without erythema or tenderness
- may present with acute swelling secondary to hemorrhage
- aseptic olecranon bursitis generally non-tender
- septic olecranon bursitis generally tender
- normal range of motion
- ability to flex & extend the elbow precludes intra-articular involvement[2]
- pain & swelling on elbow extension suggest synovitis[2]
Laboratory
- synovial fluid analysis for crystals, gram stain & cell count
- synovial fluid culture as indicated
Differential diagnosis
Management
- if infection suspected (pain, erythema, warmth), complete aspiration of fluid using sterile technique (see laboratory)
- ultrasound guidance may be indicated[5]
- drainage (repeated if necessary) may be needed for clearance of infection[6][7]
- antibiotics if bursa is infected
- supportive care (observation) for hemorrhagic olecranon bursitis[8]
- rest, ice & protection preferable to bursa aspiration[5]
- NSAIDs & rest if non-infectious
- elbow pads to prevent future occurrences
- avoid glucocorticoid injections
More general terms
Additional terms
References
- ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 673-74
- ↑ Jump up to: 2.0 2.1 2.2 2.3 Medical Knowledge Self Assessment Program (MKSAP) 11, 14, 18, 19. American College of Physicians, Philadelphia 1998, 2006, 2018, 2021.
- ↑ Jump up to: 3.0 3.1 Clyman B, in: UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
- ↑ Baumbach SF, Lobo CM, Badyine I, Mutschler W, Kanz KG. Prepatellar and olecranon bursitis: literature review and development of a treatment algorithm. Arch Orthop Trauma Surg. 2014 Mar;134(3):359-70. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24305696
- ↑ Jump up to: 5.0 5.1 5.2 5.3 Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019
- ↑ Jump up to: 6.0 6.1 Nchinda NN, Wolf JM. Clinical Management of Olecranon Bursitis: A Review. J Hand Surg Am. 2021 Jun;46(6):501-506 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33840568 Review.
- ↑ Jump up to: 7.0 7.1 Reilly D, Kamineni S. Olecranon bursitis. J Shoulder Elbow Surg. 2016 Jan;25(1):158-67. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26577126 Review.
- ↑ Jump up to: 8.0 8.1 8.2 NEJM Knowledge+ Rheumatology