The olecranon bursa is a sac like structure that lies over the prominence of the elbow. It naturally contains a small amount of fluid within it such that it helps the skin move freely over the elbow joint. However, as it is so superficial it can easily become irritated and if this continues, inflammation can occur such that an olecranon bursitis develops.
- Swelling over the prominence of the elbow
- Redness or erythema over the elbow
- Pain related to elbow movement
- Night pain
- Restricted movement secondary to pain and the progressive thickening and scarring of the bursa.
Causes & Risk factors
There are numerous causes of olecranon bursitis, some of the more common ones include;
- Repetitive trauma to the elbow. Although it is unusual for a single event to result in an olecranon bursitis, if small but repetitive injuries occur, then the bursa can become inflamed. This can more easily occur if you repeatedly lean on your elbows during work or when pursuing other activities.
- A bone spur; a small bony prominence can develop at the tip of your elbow secondary to the natural traction of your triceps tendon. Occasionally this can irritate the bursa, and if it does, a bursitis can develop.
The diagnosis of bursitis is often made purely on clinical grounds. The mainstay of the diagnosis is to determine if there is any other significant underlying diagnosis which has resulted in the bursitis. A plain X-ray or ultrasound/MRI scan may therefore also be used to help determine if there is an underlying cause that might need to be addressed. However, usually no obvious cause is found.
There are a number of treatments available for bursitis however usually the condition settles without the need for intervention.
- Conservative treatment; comprising of rest, activity modification and the use of anti-inflammatory medications.
- Injection treatments; If the bursa is only inflamed and not infected, then a local anaesthetic and cortisol injection can be given into the bursa. The anti-inflammatory component of the injection can reduce swelling and pain. However, timing of any injection is important, as you do not wish to cause an infection or indeed cause a persistent discharge form the injection site. This can occur if the inflammatory process is ongoing at the time of the injection.
- Surgery; if conservative measures have failed to address a recurring bursitis, the bursa can be surgically excised. This is termed an olecranon bursectomy.