Olecranon bursitis describes inflammation or irritation of the thin, fluid-filled sac at the bony tip of the elbow. It can occur for many reasons and may cause pain and discomfort.
The olecranon is the top part of the ulna bone in the elbow. It is the bony part of the elbow that a person may lean on. The olecranon bursa is a fluid-filled sac that covers the olecranon. It cushions the bone and skin and allows the soft tissues to move freely over the ulna bone.
The olecranon bursa is usually flat. However, if irritation or inflammation occurs, possibly due to trauma, pressure, or infection, more fluid will accumulate in the bursa and cause bursitis. While it may not cause pain or require treatment in some individuals, others may experience discomfort and need surgical treatment.
The olecranon is the end part of the ulna bone. It is the bony tip that someone can feel when they bend their elbow. A lubricated, fluid-filled thin sac, known as a
However, irritation or inflammation can cause the bursa to fill with extra fluid, which is known as bursitis. When it occurs in the olecranon bursa, it is known as olecranon bursitis, or elbow bursitis. The elbow is one of the most common sites for bursitis.
Olecranon bursitis can occur due to several factors. These can include:
- Trauma: Direct trauma, such as a fall or a blow, to the tip of the elbow can cause the bursa to produce excess fluid and swell.
- Pressure: Activities involving repetitive stress on the elbows, such as leaning on hard surfaces for long periods, can irritate and inflame the olecranon bursa. Typically, this type of bursitis develops over several months.
- Infection: In some cases, bacteria may enter the bursa sac and cause an infection. This can occur following an insect bite, scrape, puncture wound, or even without an obvious skin injury.
- Medical conditions: Certain conditions, such as arthritis or gout, can cause secondary olecranon bursitis.
Evidence notes that olecranon bursitis is more common in young and middle-aged males. Other risk factors for the condition can include certain occupations and sports.
For example, elbow bursitis is more common in professions that may involve trauma or pressure on the olecranon bursa. Examples of these roles include gardeners, carpet layers, mechanics, plumbers, roofers, truck drivers, students, and those who write regularly.
Additionally, the condition may also affect athletes who play sports involving repetitive overhead throwing, bending of the elbow, or direct impact onto the elbow. These pursuits may include gymnastics, weightlifting, football, soccer, and hockey.
Typically, a person cannot feel or see their olecranon bursa. As such, the most obvious symptom of elbow bursitis is often a noticeable bursa. Inflammation can cause thickness and swelling over the back of the elbow. As the bursa may fill with fluid, it can appear as a small, soft ball with a similar appearance to a cyst.
Many cases of olecranon bursitis are painless or only cause mild pain. It also does not always affect the movement of the elbow joint.
Health experts may classify olecranon bursitis as either nonseptic or septic. Cases of septic olecranon bursitis may present with pain, redness or discoloration, and tenderness behind the elbow.
Nonseptic cases relating to arthritis may not be painful by themselves, but a person will likely experience other symptoms, such as joint pain.
In many cases, a healthcare professional may be able to diagnose olecranon bursitis with a history and physical exam due to the appearance of the condition.
This may involve imaging studies, such as an X-ray or ultrasound, and a
Treatment for olecranon bursitis may involve nonsurgical or surgical options:
Nonsurgical treatment options are usually the initial approach for managing olecranon bursitis. However, in some cases, a person may not require any treatment, and the swelling resolves by itself.
Some treatments may include:
- Rest: Often, a healthcare professional will first recommend reducing or avoiding activities that worsen symptoms. As such, they may advise following the RICE method, which involves rest, ice, compression, and elevation.
- Anti-inflammatory medication: These drugs can help reduce pain and swelling in the elbow.
- Steroid injections: These injections may help reduce inflammation.
- Aspiration: This method involves using a needle to drain excess fluid from the bursa.
- Antibiotics: If inflammation is due to bacteria, a doctor will prescribe antibiotics to treat the infection.
If nonsurgical treatments do not effectively resolve olecranon bursitis, or if the condition is recurrent, a healthcare professional may consider surgical intervention. However, surgery is usually only necessary when an infection does not clear or if recurrent nonseptic olecranon bursitis causes pain and reduced function.
Typically, surgical techniques may involve a bursectomy, which involves removing the bursa. After the procedure, a new, noninflamed bursa typically forms in the elbow over several months.
A doctor will usually apply a splint to the arm after the procedure to protect the skin and aid recovery. They may also recommend a few specific exercises to help improve a person’s range of motion. An individual may regain full use of their elbow after a few weeks but may require padding or protection for several months to prevent re-injury.
Typically, a doctor will be able to successfully diagnose olecranon bursitis due to the distinctive swelling of the olecranon bursa.
However, other conditions may appear similarly and also cause elbow swelling. These may include:
- Rheumatoid arthritis: This condition can cause swelling over the elbow joint due to the immune system mistakenly attacking joint tissue. However, it will affect the whole joint and will likely also affect other joints.
- Septic arthritis: Infectious arthritis, which is a bacterial infection of the joint, will also cause joint swelling without local bursal swelling. Secondary septic arthritis may be a rare complication of olecranon bursitis.
- Gout and pseudogout: A buildup of crystal deposits in the joints can cause swelling and discomfort. However, it is more common in the toes and lower limbs.
- Cellulitis: This refers to a bacterial infection in the deeper layers of skin and the fat and soft tissue underneath. It may coexist with septic olecranon bursitis.
- Tennis elbow: This condition results from overusing the muscles and tendons of the forearm. It causes inflammation of the tendons that join the forearm muscles to the outside of the elbow.
- Tumors: Local bone or soft tissue tumors may also cause pain and swelling but will also present with other symptoms such as skin changes and weight loss.
Olecranon bursitis describes inflammation of the bursa on the elbow. It can occur for many reasons but is often due to trauma, overuse, or infection. It may not always cause symptoms but can cause pain and swelling on the back of the elbow.
Olecranon bursitis may not always require treatment. When it does, rest, anti-inflammatory medicines, or antibiotics are usually sufficient. In more severe cases, surgery to remove the bursa may be necessary.