Olecranon Bursitis

MANUAL MINORS

Olecranon bursitis is the inflammation of the bursa, a small fluid-filled sac that acts as a cushion between the olecranon bone (at the back of the elbow) and the skin. It can be caused by repetitive trauma, such as frequently leaning on the elbows, infections, arthritis, or even without an apparent cause. Patients typically present with visible swelling and pain at the back of the elbow, which may limit movement.

Diagnosis

The diagnosis is based on clinical history of swelling, pain, and tenderness at the back of the elbow. The inflamed bursa can be easily palpated as a soft, fluctuating lump.

In cases of infectious (septic) bursitis, there may be warmth, redness, and fever. X-rays can be helpful to rule out fractures or foreign bodies, while synovial fluid aspiration may be necessary for analysis if infection is suspected.

Differential Diagnosis

Pathology	Characteristics
Lateral epicondylitis	Pain on the outer side of the elbow, related to repetitive motions
Olecranon fracture	Acute pain after direct trauma, deformity visible on X-rays
Septic arthritis	Severe pain, fever, and warm joint; purulent joint fluid
Gout	Severe pain in the elbow with swelling, presence of urate crystals in joint fluid
Triceps tendinitis	Pain at the back of the elbow, without visible swelling

Emergency Management

Emergency management includes the use of analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) to control pain and inflammation, along with ice application to reduce swelling. If septic bursitis is suspected (fever, redness, local heat), aspiration of the bursa for fluid analysis and possible drainage is necessary. Temporary immobilisation of the elbow may help relieve symptoms.

Definitive Treatment

Definitive treatment for non-infectious bursitis includes rest, avoiding pressure on the elbow, and continuing NSAID use. In some cases, a protective pad may be recommended to prevent recurrent irritation.

If the bursitis is infectious, fluid drainage and antibiotics are required. In chronic or recurrent cases that do not respond to conservative treatment, a bursectomy (surgical removal of the bursa) may be necessary.