Olecranon bursitis
Encyclopedia
Olecranon bursitis is a condition characterised by pain, swelling and inflammation
of the olecranon
bursa located in the elbow
.
This bursa
is located over the extensor aspect of the extreme proximal end of the ulna
. In common with other bursae, it is in the normal state invisible and impalpable, and contains only a very small amount of fluid, but fulfills the function of all bursae in facilitating movement at a joint (in this case the elbow) by enabling anatomical structures to glide more easily over each other. Also in common with other bursae, it can become inflamed, producing a condition called bursitis
. This is sometimes known as a "swellbow" or "water on the elbow."
As a reaction to injury, the lining of the bursa becomes inflamed. It then secretes a much greater than normal amount of fluid into the closed cavity of the bursa, from where it has nowhere to go. The bursa therefore inflates, producing a swelling over the proximal end of the ulna which is usually inflamed and tender.
It is important to try to identify the cause of one's bursitis as early as possible. This is because long-term (chronic) bursitis is likely to eventuate into the formation of scar
which may lead to more regular flare ups and possibly further complications in later years.
The first approach in treating olecranon bursitis should be removing mechanical stress from the affected area, such as avoiding leaning on the elbow. You should identify if a repetitive activity is the cause and if so, cease this activity until your bursitis has completely healed.
Olecranon bursitis that does not heal from rest alone or which is causing pain or discomfort may then need medical intervention such as oral or topical NSAIDs or corticosteroid
injections. It is also quite common for a doctor to drain the bursitis with a syringe (aspiration), although this may still result in the fluid returning.
If the fluid continues to return after multiple drainings or the bursa is constantly causing pain to the patient, surgery to remove the bursa is an option. The minor operation removes the bursa from the elbow and is left to regrow but at a normal size over a period of ten to fourteen days. It is usually done under general anaesthetic
and has very minimal risks.
Inflammation
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...
of the olecranon
Olecranon
The olecranon is a large, thick, curved bony eminence of the forearm that projects behind the elbow.It is situated at the upper end of the ulna, one of the two bones in the forearm...
bursa located in the elbow
Elbow
The human elbow is the region surrounding the elbow-joint—the ginglymus or hinge joint in the middle of the arm. Three bones form the elbow joint: the humerus of the upper arm, and the paired radius and ulna of the forearm....
.
This bursa
Bursa (anatomy)
A bursa is a small fluid-filled sac lined by synovial membrane with an inner capillary layer of slimy fluid . It provides a cushion between bones and tendons and/or muscles around a joint. This helps to reduce friction between the bones and allows free movement...
is located over the extensor aspect of the extreme proximal end of the ulna
Ulna
The ulna is one of the two long bones in the forearm, the other being the radius. It is prismatic in form and runs parallel to the radius, which is shorter and smaller. In anatomical position The ulna is one of the two long bones in the forearm, the other being the radius. It is prismatic in form...
. In common with other bursae, it is in the normal state invisible and impalpable, and contains only a very small amount of fluid, but fulfills the function of all bursae in facilitating movement at a joint (in this case the elbow) by enabling anatomical structures to glide more easily over each other. Also in common with other bursae, it can become inflamed, producing a condition called bursitis
Bursitis
Bursitis is the inflammation of one or more bursae of synovial fluid in the body. The bursae rest at the points where internal functionaries, such as muscles and tendons, slide across bone. Healthy bursae create a smooth, almost frictionless functional gliding surface making normal movement painless...
. This is sometimes known as a "swellbow" or "water on the elbow."
Causes
Bursitis normally develops as a result either of a single injury to the elbow, or perhaps more commonly due to repeated minor injuries, such as may be caused by repeatedly leaning on the point of the elbow on a hard surface. The chance of developing bursitis is higher if one's job or hobby involves a repetitive movement, for example, tennis, golf and even repetitive computer work involving leaning on your elbow are common causes of bursitis of the elbow. The possibility of developing the condition is more common as one gets older.As a reaction to injury, the lining of the bursa becomes inflamed. It then secretes a much greater than normal amount of fluid into the closed cavity of the bursa, from where it has nowhere to go. The bursa therefore inflates, producing a swelling over the proximal end of the ulna which is usually inflamed and tender.
Treatment
As with most forms of bursitis the ideal treatment consists of rest and avoiding further injury to the area. Medical intervention will often include one or more combinations of the following: oral or topical anti-inflammatory medications such as NSAIDs, aspirating the excess with a syringe, or injecting into the bursa a hydrocortisone type medication which is aimed at relieving the inflammation and preventing further accumulation of fluid. If the bursa is infected then antibiotics may be required.It is important to try to identify the cause of one's bursitis as early as possible. This is because long-term (chronic) bursitis is likely to eventuate into the formation of scar
Scar
Scars are areas of fibrous tissue that replace normal skin after injury. A scar results from the biological process of wound repair in the skin and other tissues of the body. Thus, scarring is a natural part of the healing process. With the exception of very minor lesions, every wound results in...
which may lead to more regular flare ups and possibly further complications in later years.
The first approach in treating olecranon bursitis should be removing mechanical stress from the affected area, such as avoiding leaning on the elbow. You should identify if a repetitive activity is the cause and if so, cease this activity until your bursitis has completely healed.
Olecranon bursitis that does not heal from rest alone or which is causing pain or discomfort may then need medical intervention such as oral or topical NSAIDs or corticosteroid
Corticosteroid
Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. Corticosteroids are involved in a wide range of physiologic systems such as stress response, immune response and regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte...
injections. It is also quite common for a doctor to drain the bursitis with a syringe (aspiration), although this may still result in the fluid returning.
If the fluid continues to return after multiple drainings or the bursa is constantly causing pain to the patient, surgery to remove the bursa is an option. The minor operation removes the bursa from the elbow and is left to regrow but at a normal size over a period of ten to fourteen days. It is usually done under general anaesthetic
General anaesthetic
A general anaesthetic is a drug that brings about a reversible loss of consciousness. These drugs are generally administered by an anaesthesia provider to induce or maintain general anaesthesia to facilitate surgery...
and has very minimal risks.