Olecranon Bursitis



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Olecranon Bursitis: Bursitis is an inflammation of small sacs of fluid that help joints move smoothly. Olecranon bursitis, which affects the olecranon bursa at the back of the elbow, is sometimes called Popeye’s elbow. This is because the bump that develops at the back of the elbow looks like the cartoon character Popeye.

Symptoms:

  • Pain, especially with movement of the elbow or pressure on the elbow.
  • Swelling. One lump may be felt in the back of the affected elbow. The swelling or lump is caused by increased fluid within the bursa and is tender with movement or when touched.
  • Redness, red streaking, warmth, fever, and swollen lymph nodes in the armpit caused by infection.

  • Causes:

    There are three general causes of olecranon bursitis:

  • Inflammation, such as from pressure on the bursa or from inflammatory conditions. This is the most common cause of olecranon bursitis.
  • A sudden injury, such as a blow to the elbow, causing bleeding or fluid buildup
  • Infection caused by any of the following:

  • .......... An injury at the site of the bursa
    ...........An infection in tissue near the bursa that spreads to the bursa
    ...........A blood-borne infection. This is rare.



    Treatment:
  • Nonsurgical Treatment

  • Olecranon bursitis that is caused by an injury will usually go away on its own. The body will absorb the blood in the bursa over several weeks, and the bursa should return to normal. If swelling in the bursa is causing a slow recovery, a needle may be inserted to drain the blood and speed up the process. There is a slight risk of infection in putting a needle into the bursa.

    Chronic olecranon bursitis is sometimes a real nuisance. The swelling and tenderness get in the way and causes pain. This can create a hardship both at work and during recreational activities. Treatment usually starts by trying to control the inflammation. This may include a short period of rest. Medications such as ibuprofen and aspirin may be suggested by your doctor to control the inflammation and swelling. An elbow pad might be useful in making it easier to put the elbow on hard surfaces.

    If the bursa remains filled with fluid, a needle can be inserted and the fluid drained. During the drainage procedure, if there is no evidence of infection, a small amount of cortisone can be injected into the bursa to control the inflammation. Again, there is a small risk of infection if the bursa is drained with a needle.

    Your doctor may also prescribe professional rehabilitation to evaluate and treat the problems that are causing your symptoms. Your physical or occupational therapist may suggest the use of heat, ice, and ultrasound to help calm pain and swelling. You may be given tips and strategies to avoid repetitive elbow motion and to do your activities without putting extra pressure on your elbows.

    If an infection is found to be causing the olecranon bursitis, the bursa will need to be drained with a needle, perhaps several times over the first few days. You will be placed on antibiotics for several days.

  • Surgery

  • . . . Bursa Drainage

    If the infection is slow to heal, the bursa may have to be drained surgically. This method is different than the nonsurgical drainage mentioned earlier. Surgery to drain the bursa begins with an incision to open the bursa. The skin and bursa are kept open by inserting a drain tube into the bursa for several days. This allows the pus to drain and helps the antibiotics clear up the infection.

    . . . Bursa Removal

    Surgery is sometimes necessary to remove a thickened bursa that has not improved with any other treatment. Surgical removal is usually done because the swollen bursa is restricting your activity.

    To remove the olecranon bursa, an incision is made over the tip of the elbow. Since the bursa is outside of the elbow joint, the joint is never entered. The thickened bursa sac is removed, and the skin is repaired with stitches. Your elbow may be placed in a splint to rest the elbow and prevent it from moving for a few days. This allows the wound to begin to heal and prevents bleeding into the area where the bursa was removed.

    Some types of bursae will grow back after surgery, because the skin needs to slide over the olecranon smoothly. The body forms another bursa as a response to the movement of the olecranon against the skin during the healing phase. If all goes well, the bursa that returns after surgery will not be thick and painful, but more like a normal bursa.

  • Rehabilitation
  • What should I expect after treatment?

    . . . Nonsurgical Rehabilitation

    Chronic olecranon bursitis will usually improve over a period of time from weeks to months. The fluid-filled sac is not necessarily a problem. If it does not cause pain, it is not always a cause for alarm or treatment. The sac of fluid may come and go with variation in activity. This is normal.

    . . . After Surgery

    If surgery is required, you and your surgeon will come up with a plan for your rehabilitation. You will have a period of rest. You will also need to start a careful and gradual exercise program. Patients often work with a physical or occupational therapist to direct the exercises for their rehabilitation program after surgery.


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    ...less medical jargon in a 'Quick Glance' format!