- Relatively common condition characterised by inflammation of the subcutaneous bursa overlying the olecranon process which normally cushions the olecranon, reducing friction between it and the skin.
- Generally classified as
- Non-septic (majority)
- Septic (uncommon)
- More common in young and middle aged men. So-called student’s elbow because of the associated trauma that comes with leaning elbows on a desk
- Non septic
- Systemic conditions e.g. gout, rheumatoid arthritis
- Septic bursitis
- Prone to infection due to its superficial location under the skin and risk of injury/trauma
- Most cases are caused by Staph aureus and streptococci.
- Swelling over the olecranon process which typically occurs over hours/days.
- Can be painful, tender or warm although pain tends to disappear quite quickly
- Swelling can often be compressed (boggy) and is usually movable
- It may or may not restrict full elbow flexion
- Septic disease should be suspected if
- there is a painful, hot, red swelling which is progressively and rapidly worsening
- there is evidence of localised cellulitis
- there is a history of abrasion/laceration to the bursa
- there are signs of fever/chills or systemic upset
- patient is immunocompromised
- There may or may not be a history of overuse, trauma or irritation to the elbow
- Note that generalised joint swelling is suggestive of another cause e.g. rheumatoid; and septic arthritis should always be considered in cases of suspected septic bursitis (especially if the patient has reduced ROM limited by pain).
- Non-septic bursitis is a clinical diagnosis. If suspected septic bursitis, bursa aspiration is usually indicated.
- Imaging e.g. x-rays, are rarely used- usually in rapidly developing disease, history of trauma or where another cause is suspected e.g. fracture, joint disease)
- Pain relief (paracetamol and NSAIDs), relief on ice, rest
- Consider compression bandaging if swelling is severe
- Usually flucloxacillin 500mg QDS for 3-5 days