Olecranon Bursitis Follow-up

  • Author: Patrick M Foye, MD; Chief Editor: Sherwin SW Ho, MD   more...
 
Updated: Aug 31, 2010
 

Return to Play

The athlete with olecranon bursitis may be expected to return to play without restrictions when he/she has demonstrated resolution of symptoms and any positive physical examination findings (eg, swelling, tenderness to palpation), as well as shown adequate performance in sports-specific practice drills without recurrence of symptoms or physical examination findings.

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Complications

Complications of olecranon bursitis include progressive or persistent pain with associated difficulty in using the affected upper extremity. Potential complications due to focal corticosteroid injection include bleeding, bruising, infection, and allergic reactions. Transient elevation of blood glucose levels may occur after corticosteroid injection in a diabetic patient. Intravascular injection could potentially cause cardiac arrhythmia due to the local anesthetic component. Peripheral nerve dysfunction is possible if the injection is administered near or within a major nerve.

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Prevention

Avoid excessive pressure over the elbow. Avoid further trauma, if preventable. If an athlete plays contact sports, there may be no way to guarantee avoidance of further trauma to the site. Consider the use of elbow pads to cushion the region from further trauma.

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Prognosis

In the absence of infection, most cases of olecranon bursitis respond very well to a series of 1-2 joint aspirations (with or without corticosteroid injection) combined with the nonsurgical treatments outlined above (see Treatment). Some patients may experience recurrence of olecranon bursitis, in which even a relatively minor bump causes a significant effusion to return at this site.

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Education

The patient should be educated regarding the nature of the diagnosis, causative factors, and treatment plan for olecranon bursitis. The most important aspect of patient education is ensuring that the patient knows to immediately report any signs or symptoms of persistent drainage or infection, particularly if a corticosteroid injection has been given. Diabetic patients should be instructed that they may experience a transient increase in blood glucose levels.

Patients should be informed that symptomatic improvement from the corticosteroid usually does not begin to take effect until a few days after the injection. Patients should also understand that they may experience a transient mild increase in symptoms during the window of time when the local anesthetic has worn off but when the steroids have not begun to have a therapeutic effect.

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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, UMDNJ-New Jersey School of Medicine

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.

Scott F Nadler, DO  Assistant Director of Occupational/Musculoskeletal Medicine, Assistant Professor of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey, Director of Sports Medicine, University Hospital

Scott F Nadler, DO is a member of the following medical societies: American College of Occupational and Environmental Medicine, American College of Sports Medicine, American Medical Association, Association of Academic Physiatrists, North American Spine Society, and Physiatric Association of Spine, Sports and Occupational Rehabilitation

Disclosure: Nothing to disclose.

Specialty Editor Board

Andrew L Sherman, MD, MS  Associate Professor of Clinical Rehabilitation Medicine, Vice Chairman, Chief of Spine and Musculoskeletal Services, Program Director, SCI Fellowship and PMR Residency Programs, Department of Rehabilitation Medicine, Leonard A Miller School of Medicine, University of Miami

Andrew L Sherman, 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: pfizer Honoraria Speaking and teaching

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Henry T Goitz, MD  Academic Chair and Associate Director, Detroit Medical Center Sports Medicine Institute; Director, Education, Research, and Injury Prevention Center; Co-Director, Orthopaedic Sports Medicine Fellowship

Henry T Goitz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons and American Orthopaedic Society for Sports Medicine

Disclosure: Nothing to disclose.

Jon B Whitehurst, MD  Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital

Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America

Disclosure: Nothing to disclose.

Chief Editor

Sherwin SW Ho, MD  Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago

Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America

Disclosure: Breg, Inc. Consulting fee Consulting; Biomet, Inc. Consulting fee Consulting; GMV, Inc. Arthroscopy Simulator Evaluation and teaching; Smith and Nephew Grant/research funds Fellowship funding; DJ Ortho Grant/research funds Course funding

References

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Olecranon bursitis is shown in a patient with the elbow flexed. Image © 2007 by Patrick Foye, MD, UMDNJ New Jersey Medical School.
Olecranon bursitis is shown in a patient with the elbow extended. Image © 2007 by Patrick Foye, MD, UMDNJ New Jersey Medical School.
Olecranon bursitis is shown close up in a patient, with the elbow extended. Image © 2007 by Patrick Foye, MD, UMDNJ New Jersey Medical School.
Needle aspiration of olecranon bursitis. Image ©2007, by Patrick M. Foye, MD, UMDNJ New Jersey Medical School.
Olecranon bursitis aspiration of a hemorrhagic effusion. Image ©2007, by Patrick M. Foye, MD, UMDNJ New Jersey Medical School.
After fluid is removed from the olecranon bursa, an elastic, tubular, compressive sleeve can be used to minimize reaccumulation of the fluid. Image ©2007, by Patrick Foye, MD, UMDNJ New Jersey Medical School.
Gout. Radiograph of erosions with overhanging edges.
Arthritis, Rheumatoid. Rheumatoid nodules at the elbow. Photograph by David Effron MD, FACEP
Olecranon fracture.
Gout. Polarizing microscopy needles of urate.
 
 
 
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