Olecranon bursitis (nonseptic): Difference between revisions
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==Workup== | ==Workup== | ||
*Xrays if trauma, may consider for all to rule out bone spur as causative agent (although not emergent) | *Xrays if trauma, may consider for all to rule out bone spur as causative agent (although not emergent) | ||
*Initial aspiration is controversial<ref> Blackwell1 JR, et al. Olecranon bursitis: a systematic overview. Shoulder & Elbow; 2014, Vol. 6(3) 182–190. DOI: 10.1177/1758573214532787</ref> | *Initial aspiration is controversial<ref> Blackwell1 JR, et al. Olecranon bursitis: a systematic overview. Shoulder & Elbow; 2014, Vol. 6(3) 182–190. DOI: 10.1177/1758573214532787</ref>. 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.<ref>Baumbach SF et al. Prepatellar and Olecranon bursitis: literature review and development ofa treatment algorithm. Arch Orthop Trauma Surg. (2014) 134: 359 - 370.</ref> | ||
**If any signs of infection, must aspirate to rule out [[septic bursitis]] | **If any signs of infection, must aspirate to rule out [[septic bursitis]] | ||
**If no signs of infection: | **If no signs of infection: | ||
Revision as of 17:27, 19 August 2017
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]
Evaluation
- Bursal fluid on exam
- Non-erythematous
- FROM
- Negative axial load
Workup
- 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
Differential Diagnosis
Elbow Diagnoses
Radiograph-Positive
- Distal humerus fracture
- Radial head fracture
- Capitellum fracture
- Olecranon fracture
- Elbow dislocation
Radiograph-Negative
- Biceps tendon rupture/dislocation
- Lateral epicondylitis
- Medial epicondylitis
- Olecranon bursitis (nonseptic)
- Pronator teres syndrome
- Septic bursitis
Pediatric
- Nursemaid's elbow
- Supracondylar fracture
- Lateral epicondyle fracture
- Medial epicondyle fracture
- Olecranon fracture
- Radial head fracture
- Salter-Harris fractures
Management
- Acute
- Avoid trauma and excessive pressure
- RICE & NSAIDs
- Chronic = surgery
See Also
References
- ↑ Blackwell1 JR, et al. Olecranon bursitis: a systematic overview. Shoulder & Elbow; 2014, Vol. 6(3) 182–190. DOI: 10.1177/1758573214532787
- ↑ Blackwell1 JR, et al. Olecranon bursitis: a systematic overview. Shoulder & Elbow; 2014, Vol. 6(3) 182–190. DOI: 10.1177/1758573214532787
- ↑ Baumbach SF et al. Prepatellar and Olecranon bursitis: literature review and development ofa treatment algorithm. Arch Orthop Trauma Surg. (2014) 134: 359 - 370.
- ↑ Blackwell1 JR, et al. Olecranon bursitis: a systematic overview. Shoulder & Elbow; 2014, Vol. 6(3) 182–190. DOI: 10.1177/1758573214532787