eMedicine Specialties > Physical Medicine and Rehabilitation > Upper Limb Musculoskeletal Conditions
Olecranon Bursitis
Updated: May 2, 2008
Introduction
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.
Related eMedicine topics:
Bursitis [Emergency Medicine]
Bursitis [Orthopedic Surgery]
Olecranon Bursitis [Sports Medicine]
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
Related Medscape topic:
Resource Center Joint Disorders
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
Clinical
History
- Focal swelling at the posterior elbow is usually noticed by the patient.
- The patient may report pain at the affected site, although sometimes the swelling is painless.
- Pain often is exacerbated by pressure, such as when the patient leans on the elbow or when the patient rubs the elbow against a table while writing with the ipsilateral hand.
- Chronic recurrent swelling usually is not tender.
- Frequent bumping of the swollen elbow may occur because the elbow protrudes farther than normal.
- The patient may report a history of isolated trauma (eg, contusion) or repetitive microtrauma (such as constant rubbing of the elbow against a table while writing).
- Onset may be sudden if the condition is secondary to infection or acute trauma.
- Onset may be gradual if olecranon bursitis is secondary to chronic irritation.
Physical
- The most classic finding is posterior elbow swelling that is very clearly demarcated, appearing as a goose egg over the olecranon process.
- The affected site may be tender to palpation.
- The area may be warm and red, particularly with infection.
- Skin inspection may reveal abrasion or contusion if trauma recently occurred.
- Vital signs may reveal fever, but generally only with advanced infection.
- Elbow range of motion (ROM) usually is normal, but occasionally the end range of elbow flexion may be slightly limited because of pain.
- Patients with systemic inflammatory processes (eg, rheumatoid arthritis) or crystal deposition disease (eg, gout, pseudogout) may reveal evidence of focal inflammation at other sites.
- Upon inspection of the elbow, rheumatoid nodules may be found in patients with rheumatoid arthritis.
- If there is a history of trauma, elbow pain during active or passive ROM may increase the clinician's suspicion of fracture of the olecranon process.
Causes
- Acute trauma (such as falling onto a hard floor or a playing field with artificial turf and landing on the olecranon process)
- Minor cumulative trauma, such as repetitive rubbing of the olecranon region against a desktop during writing
- Infection resulting from abrasion or laceration at the site or owing to seeding from hematogenous spread by bacteremia
- Inflammation as part of a systemic inflammatory process (eg, rheumatoid arthritis) or a crystal deposition disease (eg, gout, pseudogout)
More on Olecranon Bursitis |
Overview: Olecranon Bursitis |
| Differential Diagnoses & Workup: Olecranon Bursitis |
| Treatment & Medication: Olecranon Bursitis |
| Follow-up: Olecranon Bursitis |
| Multimedia: Olecranon Bursitis |
| References |
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References
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Further Reading
Keywords
olecranon bursitis, septic bursitis, posterior elbow swelling, draftsman's elbow, student's elbow, miner's elbow
Overview: Olecranon Bursitis