Abstract
Olecranon bursitis may develop gradually as a result of repetitive irritation of the olecranon bursa or acutely as a result of trauma or infection. The olecranon bursa lies in the posterior aspect of the elbow between the olecranon process of the ulna and the overlying skin. It may exist as a single bursal sac or, in some patients, as a multisegmented series of loculated sacs. With overuse or misuse, these bursae may become inflamed, enlarged, and, on rare occasions, infected. The swelling associated with olecranon bursitis may be quite impressive, and the patient may complain about being unable to wear a long-sleeved shirt.
The olecranon bursa is vulnerable to injury from both acute trauma and repeated microtrauma. Acute injuries are often caused by direct trauma to the elbow in patients who play sports, such as hockey, or who fall directly onto the olecranon process. Repeated pressure from leaning on the elbow, such as when working long hours at a drafting table, may result in inflammation and swelling of the olecranon bursa. Rarely, gout or bacterial infection precipitates acute olecranon bursitis. If inflammation of the olecranon bursa becomes chronic, rice bodies may occur as may cords, as well as calcification of the bursa resulting in residual calcified nodules called gravel.
Keywords
olecranon bursitis, bursitis, septic bursitis, rice bodies, elbow pain, diagnostic ultrasonography, ultrasound guided injection, injection olecranon bursa, gout
ICD-10 CODE M70.20
Keywords
olecranon bursitis, bursitis, septic bursitis, rice bodies, elbow pain, diagnostic ultrasonography, ultrasound guided injection, injection olecranon bursa, gout
ICD-10 CODE M70.20
The Clinical Syndrome
Olecranon bursitis may develop gradually as a result of repetitive irritation of the olecranon bursa or acutely as a result of trauma or infection. The olecranon bursa lies in the posterior aspect of the elbow between the olecranon process of the ulna and the overlying skin. It may exist as a single bursal sac or, in some patients, as a multisegmented series of loculated sacs. With overuse or misuse, these bursae may become inflamed, enlarged, and, on rare occasions, infected. The swelling associated with olecranon bursitis may be quite impressive, and the patient may complain about being unable to wear a long-sleeved shirt.
The olecranon bursa is vulnerable to injury from both acute trauma and repeated microtrauma. Acute injuries are often caused by direct trauma to the elbow in patients who play sports, such as hockey, or who fall directly onto the olecranon process. Repeated pressure from leaning on the elbow, such as when working long hours at a drafting table, may result in inflammation and swelling of the olecranon bursa ( Fig. 48.1 ). Rarely, gout or bacterial infection precipitates acute olecranon bursitis. If inflammation of the olecranon bursa becomes chronic, rice bodies may occur as may cords, as well as calcification of the bursa resulting in residual calcified nodules called gravel ( Fig. 48.2 ).
Signs and Symptoms
Patients suffering from olecranon bursitis, which is also known as dialysis elbow, frequently complain of swelling and pain with any movement of the elbow, but especially with extension. The pain is localized to the olecranon area, with referred pain often noted above the elbow joint. Frequently, the patient is more concerned about the swelling than about the pain. Physical examination reveals point tenderness over the olecranon and swelling of the bursa that may be extensive ( Fig. 48.3 ). Passive extension and resisted flexion reproduce the pain, as does any pressure over the bursa. Fever and chills usually accompany infection of the bursa.
