Olecranon Bursitis

Symptoms and signs

Bursitis occurs when the bursa is irritated and inflamed and is generally classified as:
- Non-septic (most common) — sterile inflammation resulting from various causes including trauma or overuse.
- Septic — infection resulting from seeding of the bursal sac with micro-organisms, usually bacteria.
More common in:
- Young or middle-aged men.
- People in jobs which involve risk of regular elbow trauma or pressure on the bursa. E.G gardeners and mechanics.
- Athletes who play sports involving repetitive overhead throwing or elbow flexion and extension.
Most cases of olecranon bursitis resolve without complications; however, recurrent episodes may occur especially after recurrent minor trauma.
Pain and swelling over olecranon with possible erythema
Can be due to single injury or repeated minor injuries
May restrict ROM

Advice / reassurance / Analgesia & NSAIDs as appropriate
Tubigrip / compression bandage. Elbow padding
Ice
Rest /Avoidance of aggravating activity / modify loading
Aspiration and treating empirically with antibiotics until culture results are known.
Managing any associated conditions, such as gout, rheumatoid arthritis, or cellulitis.
No role for AHP services unless elbow stiffness remains once bursitis has resolved.

Referral should be considered if a person with non-septic bursitis (in whom septic bursitis has been excluded) does not respond after 2 months of conservative measures.
Urgent referral or specialist advice sought if
- A suspected septic joint (which presents with a limited range of movement of the elbow joint, unlike septic bursitis).
- Septic bursitis and severe infection or systemic toxicity.
- Abscess requiring incision and drainage, if the expertise to perform this procedure is not available.
- Extensive cellulitis.

SCI gateway/ Orthopaedic - Elbow and shoulder

Information to include when referring:

Duration and any cause of symptoms, dominance, effect on ADL, work, hobbies
Indicate site/spread of pain and if constant or intermittent, and/or waking at night
Include treatment to date (aspiration