Olecranon Bursitis

• Olecranon Bursitis:

  • inflammation of the bursa overlying the olecranon process at the proximal aspect of the ulnar
  • due to the superficial location of the bursa, it is susceptible to inflammation from a variety of mechanisms, acute or repetitive trauma, or as a result of underlying inflammatory pathology
  • it is also possible that the inflammation is due to infection, which is known as septic bursitis which is a serious pathology with the potential to destroy articular surfaces at the elbow - this would require medical management prior to being managed by a physio team
• Olecranon Bursitis:

  • what
  • inflammation of the olecranon bursa
  • septic/aseptic
  • traumatic/idiopathic
  • crystal induced/inflammatory
  • where
  • superficial to the olecranon process and proximal ulnar
  • how
  • acute/repetitive trauma or
  • inflammatory pathology or
  • infection - septic bursitis (makes about around 1/3 of all cases)
  • who
  • common in males, 30 to 60 year olds
  • sports activities involving:
  • repetitive overhead throwing / elbow flexion-extension
  • increased likelihood of direct trauma to the posterior compartment
• Olecranon Bursitis - Subjective Features:

  • swelling +/- pain over the olecranon lasting several hours to several das
  • commonly caused by acute trauma but can also be caused by repetitive trauma or be idiopathic
  • pain with pressure on olecranon e.g. learning on elbow/palpation, may also be a painless lump
  • redness/heat may be present - more common but not exclusive to septic bursitis
• Olecranon Bursitis - Objective Features:

  • observations
  • bursal oedema - swelling over the tip of the olecranon
  • +/- rubor (redness)
  • palpation
  • tenderness over the tip of the olecranon
  • +/- calor (heat)
  • chronic: small lumps over olecranon
  • ROM
  • swelling/pain can restrict end range flexion as the bursa compressed
  • special tests
  • none
  • investigations
  • traumatic: x-ray to rule out olecranon fractures
  • suspected septic: aspiration - microbiological investigation
• Olecranon Bursitis - Management:

  • advice and education:
  • if your confident its non-septic, provide reassurance
  • rest, ice, reduced activity
  • avoid direct pressure to the elbows
  • ICE, compressive bandaging
  • symptom control: NSAIDs/paracetamol
  • other:
  • if large effusion: ? aspiration to improve function and comfort
  • if septic: oral antibiotics +/- further aspiration