UMEM Educational Pearls

Olecranon bursitis

Superficial synovial membrane located overlying the proximal ulna/olecranon allows for easy irritation and inflammation

Swelling does not involve the joint

Most common bursitis (approx. 4x more common than prepatellar)

Male>>Female

Prone to trauma, inflammation or infection

            -RA, gout, overlying break in skin

Chronic inflammation results from excessive leaning on the elbow such as with certain occupations (plumber, military recruit)

Inflammation may be septic or aseptic

Usual cause is traumatic

Approximately 20% of acute cases may have a septic origin

Classically appears as a “goose egg” area on posterior elbow

            Well-demarcated and fluctuant

Small amount of swelling and/or those with minimal symptoms should be left alone and treated with activity modification, NSAIDS, ice. Suggest an elbow pad for protection.

If this does not resolve symptoms after approximately 4 weeks, consider referral for aspiration and steroid injection

If aspiration is ED performed for evaluation of possible septic bursitis, recommend a compressive elbow sleeve to help prevent reaccumulating

If a recurrent issue for patient and aspirated, consider a posterior elbow splint for approx. 10 days and refer to orthopedics.

https://upload.wikimedia.org/wikipedia/commons/thumb/6/6e/Bursitis_Elbow_WC.JPG/1200px-Bursitis_Elbow_WC.JPG