Olecranon bursitis

Olecranon bursitis
Classification and external resources
ICD-10	M70.2
ICD-9	726.33

Olecranon bursitis (also informally known as "elbow bump",^[1] "student's elbow", or "baker's elbow", is a condition characterised by pain, redness and swelling around the olecranon, caused by inflammation of the elbow's bursa. This bursa is located just over the extensor aspect of the extreme proximal end of the ulna. In common with other bursae, it is impalpable and contains only a very small amount of fluid in its normal state, and fulfills the function of facilitating the joint's movement by enabling anatomical structures to glide more easily over each other.

Causes

Hard blow to the tip of the elbow on a wall

Bursitis normally develops as a result either of a single injury to the elbow (e.g., a hard blow to the tip of the elbow), or perhaps more commonly due to repeated minor injuries, such as repeated 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 (e.g., tennis, golf, or even repetitive computer work involving leaning on one's elbow). The possibility of developing the condition is more common as one gets older.^[2]

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.

Another possible cause of inflammation of the bursa is infection, which can usually (but not always) be traced to a crack or other lesion in the skin which allowed for bacteria of the normal skin flora to invade deeper layers of tissue.^[3]

Symptoms

Symptoms include swelling in the elbow, which can sometimes be large enough to restrict motion. There is pain originating in the elbow joint from mild to severe which can spread to the rest of the arm.

If the bursa is infected, there also will be prominent redness and the skin will feel very warm. Another symptom would include the infected bursa possibly opening spontaneously and draining pus.^[3]

Treatments

Non-surgical treatments

Conservative management of minor cases involves icing, a firm compression bandage, and avoidance of the aggravating activity. This can also be augmented with oral or topical anti-inflammatory medications such as NSAIDs. Elbow padding can also be used for symptomatic relief. Treatment for more severe cases may include aspirating the excess bursa fluid with a syringe (draining of the bursa), or injecting into the bursa a hydrocortisone type medication which is aimed at relieving the inflammation and preventing further accumulation of fluid.

In case of infection, the bursitis should be treated with an antibiotic.^[3]

Surgical treatments

If the fluid continues to return after multiple drainings or the bursa is constantly causing pain to the patient, surgery^[4] 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 minimal risks. The surgery does not disturb any muscle, ligament, or joint structures. To recover from surgical removal a splint will be applied to the arm to protect the skin. Exercises will be prescribed to improve range of motion.^[3]

References