Olecranon bursitis: a systematic overview

Abstract

Background: Olecranon bursitis is a common condition where the bursal cavity, superficial to the olecranon, becomes inflamed. This can occur either with or without infection and has been given pseudonyms relating to the repeated minor trauma from external pressure that often predisposes. As a result of the multiple aetiologies, olecranon bursitis can present to any medical specialty with reasonable frequency and, although many therapies are described, a single, evidence-based and standardized treatment pathway is not well described.

Methods: We summarize the key points within the literature and subsequently propose an evidence-based treatment pathway.

Results: Relevant evidence is presented from appropriate publications to add rational to existing decision-making processes, together with personal experience and suggested operative bursectomy techniques from an established upper limb surgeon. The common and significant aetiologies are summarized and, in particular, red flag symptoms are highlighted by way of warning to the unsuspecting investigator.

Conclusions: The conclusion is provided in diagrammatic form, providing a suggested treatment pathway from history and examination through to operative intervention.

Keywords: Bursitis; bursectomy; inflammation; olecranon; orthopaedics; trauma.

Figure 1.

Cross-sectional anatomy of elbow joint.

Figure 2.

Recurrence of sarcoma indicated by arrows following initial debridement.

Figure 3.

Infected olecranon bursitis in the presence of gouty tophi.

Figure 4.

Magnetic resonance images of enhancing olecranon bursitis.

Figure 5.

Infiltration of 5 mL of normal saline to identify and delineate bursal sac.

Figure 6.

Elliptical skin incision.

Figure 7.

Skin excised with bursa visible in floor of wound.

Figure 8.

Skin closure demonstrating elliptical conversion of spherical skin marking.

Figure 9.

Proposed treatment algorithm.