olecranon bursitis

Question 1

what is olecranon bursitis?

Answer 1

inflamation of the bursa over the bony prominence of the ulna, called the olecranon

Question 2

what can cause inflamation of the bursa?

Answer 2

Friction from repetitive movements or leaning on the elbow
Trauma
Inflammatory conditions (e.g., rheumatoid arthritis or gout)
Infection – referred to as septic bursitis

Question 3

who does olceranon bursitis present in?

Answer 3

people with occupations which require leaning on elbows

• student
• drivers
• plumbers

Question 4

how does ocleranon bursitis present?

Answer 4

The typical presentation is a young/middle-aged man with an elbow that is:

Swollen
Warm
Tender
Fluctuant (fluid-filled)

Question 5

how can oclerenon bursitis be distinguished from septic arthritis?

Answer 5

An important differential diagnosis is septic arthritis. Consider septic arthritis if there is:

Swelling in the joint (rather than the bursa)
Painful and reduced range of motion in the elbow

Question 6

when should the fluid be aspirated and what do the different colours suggest?

Answer 6

Pus indicates infection

Straw-coloured fluid indicates infection is less likely

Blood-stained fluid may indicate trauma, infection or inflammatory causes

Milky fluid indicates gout or pseudogout

Aspiration should ideally be performed before starting antibiotics. The fluid is sent to the lab for microscopy and culture.

During microscopy, they will examine for crystals (gout and pseudogout) and gram-staining for bacteria.

Question 7

what is the management for olecranon bursitis?

Answer 7

Rest
Ice
Compression
Analgesia (e.g., paracetamol or NSAIDs)
Protecting the elbow from pressure or trauma
Aspiration of fluid may be used to relieve pressure
Steroid injections may be used in problematic cases where infection has been excluded

Question 8

which antibiotics are used if an infective cause is suspected?

Answer 8

The NICE CKS recommend flucloxacillin first-line, with clarithromycin as an alternative.