Olecranon bursitis (nonseptic)

Background
  • Inflamation of the bursal cavity superficial to the olecranon
  • Majority of cases are not infectious, but inflammation can be from infection (septic bursitis)
  • Also known as "student's elbow" or "baker's elbow"
  • Often caused by repeated minor trauma from external pressure to elbow
  • There is controversy regarding initial diagnosis and treatment[1]

Clinical Features
Olecranon bursitis, nonseptic
  • Bursal fluid on exam
  • Non-erythematous
  • FROM
  • Negative axial load

Differential Diagnosis

Elbow Diagnoses

Radiograph-Positive

Radiograph-Negative

Pediatric

Evaluation
  • Xrays if trauma, may consider for all to rule out bone spur as causative agent (although not emergent)
  • Initial aspiration is controversial[2]. There is currently no consensus on the optimal diagnosis strategy for prepatellar bursitis. The majority of patients studied did receive an aspiration of fluid (82%), but those patients had a significantly higher rate of complications (persistent infection, secondary infection in initially aseptic bursae) than patients treated with antibiotics alone.[3]
    • If any signs of infection, must aspirate to rule out septic bursitis
    • If no signs of infection:
      • May consider initial conservative (no aspiration) treatment for several days[4]
      • Some sources suggest aspiration for all cases

Management
  • Acute
    • Avoid trauma and excessive pressure
    • RICE & NSAIDs
  • Chronic = surgery

Disposition
  • Outpatient management

See Also

References
  1. Blackwell1 JR, et al. Olecranon bursitis: a systematic overview. Shoulder & Elbow; 2014, Vol. 6(3) 182–190. DOI: 10.1177/1758573214532787
  2. Blackwell1 JR, et al. Olecranon bursitis: a systematic overview. Shoulder & Elbow; 2014, Vol. 6(3) 182–190. DOI: 10.1177/1758573214532787
  3. Baumbach SF et al. Prepatellar and Olecranon bursitis: literature review and development ofa treatment algorithm. Arch Orthop Trauma Surg. (2014) 134: 359 - 370.
  4. Blackwell1 JR, et al. Olecranon bursitis: a systematic overview. Shoulder & Elbow; 2014, Vol. 6(3) 182–190. DOI: 10.1177/1758573214532787
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