Olecranon Bursitis

Olecranon bursitis is a condition in which the pointed bone at the tip of your elbow (the olecranon) becomes irritated and/or inflamed. As a result of this, the small sac of fluid (the olecranon bursa) at the tip of your elbow fills up with extra fluid.The result is usually a swelling (and sometimes pain) at the back of the elbow. This condition is alternatively referred to as elbow bursitis. It can happen either gradually over time or as the result of an instantaneous blow to your elbow.

To treat a case of olecranon bursitis, your doctor may extract the extra fluid from the olecranon bursa and send it for laboratory testing to determine if an infection is present. In other cases, your doctor will suggest that you temporarily refrain from activities that involve leaning on the tip of your elbow. This will allow the bursa to rest and recover naturally. In some case, surgery may be necessary to completely remove the injured bursa.

Causes & Risk Factors

Causes

In general, olecranon bursitis can arise from one  (or more) of four different causes:

• A blow to the tip of the elbow, e.g. from falling onto it;
• Prolonged pressure to the tip of the elbow, if you are in a job that requires extended leaning on your elbows;
• An infection, such as may arise from an insect bite or puncture wound that leaves a point of entry for harmful bacteria;
• The presence of certain types of inflammatory arthritis in the elbow joint. Examples of these may be rheumatoid arthritis and gout. Over time, these conditions can then develop into olecranon bursitis as a side effect.

Risk Factors

Based on the causes enumerated above, the following situations can elevate your risk of developing elbow bursitis:

• Working in a job in which you have to spend significant periods of time crawling through narrow spaces on your hands and knees. Examples of such jobs include plumbing or air conditioning/heating system technicians. These conditions can also increase your exposure to knee bursitis;
• In some cases, individuals who spend long periods sitting at a desk and working on a computer may develop a habit of leaning on the desk. In doing so, they place their weight on the tips of their elbows. This puts prolonged pressure on the elbow bursa and may cause it to become irritated and inflamed over time. Doctors sometimes refer to olecranon bursitis that develops from this type of activity as “student’s elbow”;
• Playing a sport in which you frequently fall in an uncontrolled fashion and may land on your elbow tips. This type of event can cause significant trauma to the elbow bursa and lead to olecranon bursitis;
• If you have inflammatory arthritis as a pre- existing condition, you are at a higher risk of developing elbow bursitis.

Symptoms Of Olecranon Bursitis

The signs and symptoms of olecranon bursitis are typically as follows:

• A gradual swelling at the bony tip of your elbow (see featured photo for this post). Because the skin behind the elbow is somewhat loose, you may not notice this swelling for a while;
• After a while, the swelling may become large enough that it may interfere with your elbow range of motion;
• In some cases the tip of the elbow may become painful;
• Especially if an infection is present, you may experience warmth, redness and tenderness at the tip of your elbow;
• Also in cases of infection, the swelling at the back of your elbow can occasionally open and drain pus;
• You may also experience a fever as your body fights any infection that may be present.

If you do not take action to treat it, olecranon bursitis can cause infection to spread to other parts of your body. Should the infection get into your bloodstream, this can result in a serious and possibly even life threatening condition. As a result, if you experience any of the symptoms above, you should see your doctor for an examination.

Diagnosis

To diagnose the cause of the condition, your doctor will physically examine your elbow. He or she may also want to know about recent falls or other accidents in which you hurt your elbow.

In addition to a physical examination, your doctor may request an X Ray scan of your elbow. This will be to look for foreign objects that may be present at the back of the elbow. Bone spurs in particular tend to be associated with elbow bursitis caused by infection.

If your doctor suspects the presence of an infection, (s)he may remove some of the fluid from the bursa with a needle and send it for laboratory testing. He or she may also request blood tests to check for the presence of an infection.

Conservative Treatment Of Elbow Bursitis

If your doctor suspects that your olecranon bursitis is due to an infection, (s)he may prescribe a general purpose antibiotic, pending the results of the lab analysis of the fluid extracted from your bursa. Should the lab results confirm that the bursa is infected, your doctor may then prescribe another antibiotic that is specifically designed to fight the type of infection the lab has found.

If, on the other hand, your bursitis is not due to an infection, your doctor may recommend  that you:

• Temporarily avoid activities that may irritate your bursa;
• Wear an elbow pad for further protection of the affected elbow;
• Take an over the counter oral anti inflammatory medication such as Ibuprofen;
• Once your bursitis shows signs of healing, participate in a physical therapy program to restore your elbow’s range of motion.

If the above treatments do not work, your doctor may remove all of the fluid from the bursa using a needle. This process is called aspiration. He or she may then replace the fluid with a powerful anti inflammatory agent. This is usually done by way of a corticosteroid injection.

Surgery

Should all the above treatments  fail to heal your olecranon bursitis, your doctor may recommend surgery. This is usually done on an out patient basis. The surgeon will remove the entire bursa, leaving a new one to grow in its place in a few months’ time.

You should expect your surgical wound to take about 12-16 days to heal. After around 3-4 weeks, you should have regained normal use of your elbow.