Physical Medicine and Rehabilitation for Olecranon Bursitis 

  • Author: Patrick M Foye, MD; Chief Editor: Rene Cailliet, MD   more...
 
Updated: Jan 18, 2012
 

Background

Olecranon bursitis is inflammation of the bursa overlying the olecranon process at the proximal aspect of the ulna.[1] The bursa is located between the ulna and the skin at the posterior tip of the elbow. (See following images.)

Olecranon bursitis, shown here with the elbow flexOlecranon bursitis, shown here with the elbow flexed. Image courtesy of UMDNJ-New Jersey Medical School, www.DoctorFoye.com, and www.TailboneDoctor.com. Olecranon bursitis seen with the elbow extended; tOlecranon bursitis seen with the elbow extended; the focal olecranon swelling is more visible than it is when the elbow is flexed. Image courtesy of UMDNJ-New Jersey Medical School, www.DoctorFoye.com, and www.TailboneDoctor.com. Olecranon bursitis seen with the elbow extended. IOlecranon bursitis seen with the elbow extended. Image courtesy of UMDNJ-New Jersey Medical School, www.DoctorFoye.com, and www.TailboneDoctor.com
Next

Pathophysiology

Normally, the olecranon bursa prevents tissue tears by providing a mechanism with which the skin can glide freely over the olecranon process. Bursal inflammation may be caused by a variety of mechanisms. Owing to its superficial location, this bursa is susceptible to inflammation from either acute or repetitive (cumulative) trauma. Less commonly, inflammation may result from infection (septic bursitis).[2, 3, 4] (See following image.)

Olecranon bursogram: this image shows a needle injOlecranon bursogram: this image shows a needle injecting contrast material into the olecranon bursa, under fluoroscopic guidance. Although olecranon bursa aspiration/injection usually does not require fluoroscopy or contrast, employing fluoroscopy here demonstrates the outline of the involved bursa. Image ©2005, by Patrick M. Foye, MD, UMDNJ: New Jersey Medical School.
Previous
Next

Epidemiology

Frequency

United States

This condition is relatively common.

Mortality/Morbidity

  • Generally, no mortality is associated with this condition.
  • Pain at the posterior elbow may cause morbidity, limiting some functional activities, such as writing. Complications of aspiration/injection include recurrence, infection, and persistent drainage.

Race

No racial predisposition is recognized.

Sex

No predisposition for either sex is recognized.

Age

This condition occurs in children and adults. In patients on long-term hemodialysis treatment, uremia or a mechanical factor (such as resting the posterior elbow during hemodialysis treatment) is thought possibly to cause the inflammation.[5]

Previous
Proceed to Clinical Presentation
 
 
Contributor Information and Disclosures
Author

Patrick M Foye, MD  Associate Professor of Physical Medicine and Rehabilitation, Co-Director of Musculoskeletal Fellowship, Co-Director of Back Pain Clinic, Director of Coccyx Pain Service (Tailbone Pain Service: www.TailboneDoctor.com), University of Medicine and Dentistry of New Jersey, New Jersey Medical School

Patrick M Foye, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, Association of Academic Physiatrists, and International Spine Intervention Society

Disclosure: Nothing to disclose.

Coauthor(s)

Todd P Stitik, MD  Professor, Department of Physical Medicine and Rehabilitation, Director, Outpatient Occupational/Musculoskeletal Medicine, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Todd P Stitik, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists, Phi Beta Kappa, and Physiatric Association of Spine, Sports and Occupational Rehabilitation

Disclosure: Nothing to disclose.

Dev Sinha, MD  Resident Physician, Department of Physical Medicine and Rehabilitation, University of Pennsylvania Health Systems

Disclosure: Nothing to disclose.

Specialty Editor Board

Robert L Sheridan, MD  Assistant Chief of Staff, Chief of Burn Surgery, Shriners Burns Hospital; Associate Professor of Surgery, Department of Surgery, Division of Trauma and Burns, Massachusetts General Hospital and Harvard Medical School

Robert L Sheridan, MD is a member of the following medical societies: American Academy of Pediatrics, American Association for the Surgery of Trauma, American Burn Association, and American College of Surgeons

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Michael T Andary, MD, MS  Professor, Residency Program Director, Department of Physical Medicine and Rehabilitation, Michigan State University College of Osteopathic Medicine

Michael T Andary, MD, MS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Medical Association, and Association of Academic Physiatrists

Disclosure: Allergan Honoraria Speaking and teaching; Pfizer Honoraria Speaking and teaching

Kelly L Allen, MD  Medical Director, Medevals

Disclosure: Nothing to disclose.

Chief Editor

Rene Cailliet, MD  Professor-Chairman Emeritus, Department of Rehabilitation Medicine, University of Southern California School of Medicine; Former Director, Department of Rehabilitation Medicine, Santa Monica Hospital Medical Center

Rene Cailliet, MD is a member of the following medical societies: American Academy of Pain Medicine, American Academy of Physical Medicine and Rehabilitation, American Pain Society, Association of American Medical Colleges, International Association for the Study of Pain, and Pan American Medical Association

Disclosure: Nothing to disclose.

Additional Contributors

Debra Ibrahim, 4th year medical student, New York College of Osteopathic Medicine, Class of 2008, assisted with the 2007 revision of this manuscript.

Jason Lee, 4th year medical student, St. George's University School of Medicine, Class of 2010, assisted with the most recent revision of this manuscript.

References

  1. Snider RK. Olecranon bursitis. In: Snider RK, ed. Essentials of Musculoskeletal Care. Rosemont, Ill: American Academy of Orthopaedic Surgeons; 1997:156-9.

  2. Wasserman AR, Melville LD, Birkhahn RH. Septic bursitis: a case report and primer for the emergency clinician. J Emerg Med. Jul 20 2007;[Medline].

  3. Lass-Flörl C, Mayr A. Human protothecosis. Clin Microbiol Rev. Apr 2007;20(2):230-42. [Medline]. [Full Text].

  4. Wagner C, Iking-Konert C, Hug F, Stegmaier S, Heppert V, Wentzensen A, et al. Cellular inflammatory response to persistent localized Staphylococcus aureus infection: phenotypical and functional characterization of polymorphonuclear neutrophils (PMN). Clin Exp Immunol. Jan 2006;143(1):70-7. [Medline]. [Full Text].

  5. Senécal L, Leblanc M. Olecranon bursitis in chronic haemodialysis patients. Nephrol Dial Transplant. Sep 2001;16(9):1956-7. [Medline]. [Full Text].

  6. Wessolossky M, Haran JP, Bagchi K. Paecilomyces lilacinus olecranon bursitis in an immunocompromised host: case report and review. Diagn Microbiol Infect Dis. Jul 2008;61(3):354-7. [Medline].

  7. Turan H, Serefhanoglu K, Karadeli E, et al. A case of brucellosis with abscess of the iliacus muscle, olecranon bursitis, and sacroiliitis. Int J Infect Dis. Apr 23 2009;[Medline].

  8. Malkin J, Shrimpton A, Wiselka M, et al. Olecranon bursitis secondary to Mycobacterium kansasii infection in a patient receiving infliximab for Behcet's disease. J Med Microbiol. Mar 2009;58:371-3. [Medline].

  9. Blankstein A, Ganel A, Givon U, et al. Ultrasonographic findings in patients with olecranon bursitis. Ultraschall Med. Dec 2006;27(6):568-71. [Medline].

  10. Floemer F, Morrison WB, Bongartz G, et al. MRI characteristics of olecranon bursitis. AJR Am J Roentgenol. Jul 2004;183(1):29-34. [Medline]. [Full Text].

  11. Tran N, Chow K. Ultrasonography of the elbow. Semin Musculoskelet Radiol. Jun 2007;11(2):105-16. [Medline].

  12. Olsen NK, Press JM, Young JL. Bursal injections. In: Lennard TA, ed. Physiatric Procedures in Clinical Practice. Philadelphia, Pa: Hanley & Belfus; 1995:36-43.

  13. Schumacher HR. Arthrocentesis, synovial fluid analysis, and synovial biopsy. In: Schumacher HR, ed. Primer on Rheumatic Diseases. 10th ed. Atlanta, Ga: Arthritis Foundation; 1993:67-72.

  14. Degreef I, De Smet L. Complications following resection of the olecranon bursa. Acta Orthop Belg. Aug 2006;72(4):400-3. [Medline].

  15. Weinstein PS, Canoso JJ, Wohlgethan JR. Long-term follow-up of corticosteroid injection for traumatic olecranon bursitis. Ann Rheum Dis. Feb 1984;43(1):44-6. [Medline]. [Full Text].

  16. Cardone DA, Tallia AF. Diagnostic and therapeutic injection of the elbow region. Am Fam Physician. Dec 1 2002;66(11):2097-100. [Medline].

  17. Green SM. Nonsteroidal anti-inflammatory drugs (NSAIDs). In: Tarascon Pocket Pharmacopoeia 2000. Loma Linda, Calif: Tarascon; 2000:11-2.

  18. Friedman ND, Sexton DJ. Bursitis due to Mycobacterium goodii, a recently described, rapidly growing mycobacterium. J Clin Microbiol. Jan 2001;39(1):404-5. [Medline]. [Full Text].

  19. Brinker MR, Miller MD. The adult elbow. In: Fundamentals of Orthopaedics. Philadelphia, Pa: WB Saunders; 1999:153-64.

  20. Lennard TA. Fundamentals of procedural care. In: Lennard TA, ed. Physiatric Procedures in Clinical Practice. Philadelphia, Pa: Hanley & Belfus; 1995:1-13.

  21. McGee DJ. Elbow joints. In: Orthopedic Physical Assessment. 2nd ed. Philadelphia, Pa: WB Saunders; 1992:143-67.

  22. Morgan WJ. Elbow and forearm. In: Steinberg GG, Akins CM, Baran DT, eds. Orthopaedics in Primary Care. 3rd ed. Baltimore, Md: Lippincott Williams & Wilkins; 1999:70-98.

  23. Strakowski JA, Wiand JW, Johnson EW. Upper limb musculoskeletal pain syndromes. In: Braddom RL, ed. Physical Medicine and Rehabilitation. Philadelphia, Pa: WB Saunders; 1996:756-82.

 
Previous
Next
 
Olecranon bursitis, shown here with the elbow flexed. Image courtesy of UMDNJ-New Jersey Medical School, www.DoctorFoye.com, and www.TailboneDoctor.com.
Olecranon bursitis seen with the elbow extended; the focal olecranon swelling is more visible than it is when the elbow is flexed. Image courtesy of UMDNJ-New Jersey Medical School, www.DoctorFoye.com, and www.TailboneDoctor.com.
Olecranon bursitis seen with the elbow extended. Image courtesy of UMDNJ-New Jersey Medical School, www.DoctorFoye.com, and www.TailboneDoctor.com
Olecranon bursogram: this image shows a needle injecting contrast material into the olecranon bursa, under fluoroscopic guidance. Although olecranon bursa aspiration/injection usually does not require fluoroscopy or contrast, employing fluoroscopy here demonstrates the outline of the involved bursa. Image ©2005, by Patrick M. Foye, MD, UMDNJ: New Jersey Medical School.
Needle aspiration of olecranon bursitis. Image courtesy of UMDNJ-New Jersey Medical School, www.DoctorFoye.com, and www.TailboneDoctor.com.
Olecranon bursitis aspiration of a hemorrhagic effusion. Image courtesy of UMDNJ-New Jersey Medical School, www.DoctorFoye.com, and www.TailboneDoctor.com.
After fluid is removed from the olecranon bursa, an elastic tubular compressive sleeve can be used to minimize repeat accumulation of the fluid. Image courtesy of UMDNJ-New Jersey Medical School, www.DoctorFoye.com, and www.TailboneDoctor.com.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.