olecranon bursitis

Question 1

what is olecranon bursitis?

Answer 1

inflammatory condition, occouring due to superficial position of bursa making in vulnerable to pressure and trauma

Question 2

why do patients develope it?

Answer 2

repetitive flexion-extension movements of the elbow, causing irritation of the bursa.

can also be caused through skin abrasion or puncture, or gout or RA

Question 3

what are the clinical features of it?

Answer 3

• pain and swelling over elbow, recently increasing in size
• preserved ROM
• if infected, may have systemic symptoms e.g fever or lethargy
• examine the contralateral elbbow joint

Question 4

what are your differentials?

Answer 4

• inflammatory arthoropathies
• gout
• cellulitis
• septic arthiritis

Question 5

what investigations should be done?

Answer 5

• bloods including CRP and FBC. investigate rheumatological causes. check serum urate levels if history is suggestive of gout
• Plain film radiograph will rule out bony injury
• aspirate fluid to be sent for microscopy and for culture to asses for evidence of infection and for the presence crystals. Also can provide symptomatic relief

Question 6

how can it be managed?

Answer 6

• treat dependant if there is infection
• no infection = analgesia by NSAIDs and rest, splint the elbow and if swelling is large and uncomfortable can undergo washout in theatre.
• infection = IV antibiotics and surgical drainage. bursectomy can be done as well if case is prolonged.

Question 7

what are the complications of bursitis?

Answer 7

Rarely, septic arthritis or osteomyelitis can develop in infective cases, which will likely need surgical intervention.