Bursitis
Olecranon Bursitis
Bursas are liquid-filled sacs that create cushioning between bones and tendons. When bursas become swollen or inflamed, bursitis results.
This condition is fairly common and is generally marked by a golf-ball-sized sphere appearing under the elbow's skin. Olecranon bursitis occurs at the elbow's point when the olecranon bursa, located between the skin and bone, is inflamed.
The role of the olecranon bursa is to allow for effective elbow joint movement and decrease the amount of friction. The structure of the bursa supports this role, as it contains lubricating fluid. However, the fluid accumulates when the bursa is irritated, making it larger.
Elbow bursitis can range from peanut size to tennis ball size. As the bursa becomes larger, the likelihood of movement restriction and pain increases.
Causes of Bursitis
Various factors can lead to the development of elbow bursitis, including:
- Continual pressure on the elbow, such as leaning the elbow on firm exteriors
- Trauma to the elbow, such as knocking it during a fall or injury
- Infection from an insect bite or other skin-breaking injury
- Diseases, including diabetes, rheumatoid arthritis or gout.
There are some activities and occupations which put you at risk of elbow bursitis development. This includes some construction workers and plumbers who must crawl with their elbows regularly, which can progressively irritate elbow bursas.
Symptoms of Bursitis
Elbow swelling commonly indicates bursitis. Some individuals may not notice swelling for a period of time due to differences in elbow skin looseness. However, pain is often experienced as the bursa continues to expand and stretch, and this pain may increase when pressure is applied (for example, when bending the elbow). Elbow tenderness, warmth and redness appear when the bursa becomes infected. Fevers may also be experienced, and the bursa may split, spreading bacteria to the bloodstream.
Diagnosis of Elbow Bursitis
Dr Oscar Brumby-Rendell will discuss your medical history and symptoms, and will then professionally examine your elbow. There may be no need for further testing if the physical examination sufficiently indicates bursitis. However, an X-ray may be ordered if Dr Brumby-Rendell thinks a bone spur or foreign body may be causing bursitis. If the condition is associated with conditions such as gout or arthritis, blood tests may also be conducted. Infection must also be assessed if you have elbow redness or warmth. This happens by extracting (with a needle) a small amount of fluid from your bursa, which will be viewed and evaluated by a pathologist.
Treatment
Non-Surgical Treatments
Olecranon bursitis is treated with conservative, non-invasive treatments where possible. Such measures may include:
- The consumption of anti-inflammatory medication (including Ibuprofen)
- Using a needle to drain the fluid
- Utilising an elbow wrap or elbow pads
- Resting the elbow
- Performing specially designed mobilising exercises
- Consumption of antibiotics (if your elbow is infected)
Elbow surgery may be beneficial if these measures do not resolve your symptoms.
Surgical Treatments
Endoscopic surgery may be performed by Dr Brumby-Rendell to remove the bursa. This depends on the lesion's size. Endoscopy ('keyhole surgery') is minimally invasive and therefore results in reduced infection risks and faster recovery periods than procedures that require the creation of large open wounds. This surgery is generally performed during the day, with the patient under general anaesthetic. A 6cm cut is made to the elbow's back, and small surgical instruments and a tiny camera are inserted through it. The lighted camera enables Dr Brumby-Rendell to clearly view the surgical site and conduct the operation internally.
A rotational skin flap may be needed for cases with large lesions, as a large amount of space would otherwise be left after bursa removal. In these cases, Dr Brumby-Rendell will need to make a larger incision to prevent the recurrence of the condition and promote proper healing.
After the procedure is completed, the surgical tools are removed, the incision stitched, and the dressing applied to the wound. Generally, this surgery is completed within an hour, with no need for an overnight hospital stay. A compression bandage is often placed on the elbow to reduce the risk of fluid accumulation, but the elbow can be moved directly after the procedure. Your body will create a new bursa as your recover, which will assist proper elbow movement.
Normally, everyday activities can be recommenced within 2 weeks of surgery. Patients who work in industries that require manual labour may require alternative, lighter duties for a given recovery period.
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