What is a bursitis elbow?
A bursa is a cushion of tissue lying between skin and tendons and bone. In the elbow, the olecranon bursa lies over the undersurface of the elbow and allows flexibility, cushioning and stretching of the skin when we bend our elbows. The bursa can become fluid-filled and inflamed leading to bursitis. This can be secondary to exercise, repeated activities and direct pressure in this area. In some cases, this can occur secondary to inflammatory arthritis, for example, rheumatoid arthritis and gout, which can also lead to other tissue thickenings and joint pains.
What are the symptoms of elbow bursitis?
The main symptoms are usually pain and swelling. Patients in more chronic cases complain of the significant size of the bursa which can be difficult with clothing and lead to poor cosmesis. Inflammatory flares of an elbow bursitis can lead to loss of function of the arm and be extremely debilitating. In some cases, the bursa can become infected.
How is it diagnosed?
It is diagnosed by taking a careful history and performing a detailed examination. It is important to exclude other potential causes and assess for other diagnoses such as inflammatory arthritis. Blood tests, Xray, ultrasound and MRI scan are extremely important to exclude other pathology within the joint and to help to exclude infective causes.
How is it treated?
Treatment begins with symptomatic management including pain killers and rest. Avoidance of any activities causing direct pressure on the elbow is extremely important. In certain professions, the use of elbow pads is essential to prevent a recurrence. Injections and aspirations are typically avoided to prevent any seeding of infection and as they are unlikely to lead to long term improvement.
For more prolonged cases failing to respond to these simple measures, a careful discussion with the patient regarding the options will be undertaken. A surgical excision is an option for certain cases and the individual risks and benefits can be discussed with the surgeon.