Olecranon bursitis

The most common symptom of olecranon bursitis is visible and palpable swelling at the tip of the elbow. This swelling may appear suddenly or gradually. In non-infectious cases, the pain is usually moderate, although leaning on the elbow, such as when resting on a hard surface, can exacerbate it. However, if the bursa is infected, the area becomes red, hot to the touch, and painful, sometimes accompanied by fever.

Some people may experience discomfort when bending or fully extending the elbow, without any significant loss of mobility. In chronic cases, a persistent soft mass may remain, without any noticeable pain.

Olecranon bursitis can have various causes. One of the most common is direct trauma, such as impact with a hard surface. Repeated microtrauma due to prolonged pressure, for example from frequently leaning on the elbows, is also a contributing factor.

Infectious causes are also possible, particularly when a skin lesion allows bacteria, such as Staphylococcus aureus, to enter the bursa. Chronic inflammatory conditions such as rheumatoid arthritis, gout, or lupus can also cause inflammation of the bursa, as can certain metabolic disorders such as diabetes or immunosuppression.

The diagnosis is often made on the basis of a clinical examination. The doctor observes localized swelling on the olecranon, often rounded, resembling a “water ball” under the skin. In the absence of infection, the pain is moderate and elbow mobility is preserved.

When infection is suspected (redness, local heat, fever, intense pain), a puncture of the bursa may be performed. The fluid collected is analyzed in the laboratory to check for the presence of bacteria or crystals (in cases of suspected gout).

Additional tests such as X-rays may be useful to check for an associated fracture or the presence of osteophytes. If there is any doubt about a deeper injury or complication (abscess, bone damage), an MRI may be indicated.

Non-surgical treatment

In most non-infectious cases, treatment is based on conservative measures. Resting the joint, applying ice several times a day, and using a protective pad often relieve symptoms. Non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed to reduce pain and inflammation. In addition, compression with an elastic bandage can help limit swelling.

If symptoms persist despite these measures, the fluid may be drained, possibly followed by an injection of corticosteroids into the bursa. This procedure quickly reduces inflammation, although the risk of infection requires careful evaluation.

Treatment for infectious bursitis

If infection is suspected or confirmed, puncture is essential for both diagnostic and therapeutic purposes. Antibiotic therapy is adjusted according to the culture results. If the response is insufficient, hospitalization may be necessary.

Surgical treatment

Surgery is considered for resistant or recurrent forms, whether infectious or not. It involves removing the bursa (bursectomy). This procedure is performed on an outpatient basis, with rapid functional recovery. The bursa tends to reform naturally over time, without inflammation.

Olecranon bursitis progresses favorably in most cases, especially when treated early. Non-infectious forms generally heal with conservative treatments. However, certain complications may arise.

Among these, secondary infection of the bursa is a major risk. If fluid accumulates chronically, the bursa can become sclerotic, making recurrences more frequent. In untreated infectious cases, the infection can spread to neighboring tissues or even to the bone (osteomyelitis), requiring urgent surgical treatment.

Repeated episodes can lead to persistent functional discomfort or chronic pain, affecting quality of life. Finally, although rare, chronic olecranon bursitis can be confused with a soft tissue tumor, hence the importance of a rigorous differential diagnosis.

Prevention is primarily based on reducing repetitive mechanical factors. The use of elbow protection, especially during manual labor or high-risk sports activities, is strongly recommended. Prolonged leaning on the elbows, especially on hard surfaces, should be avoided.

Patients with chronic conditions such as gout or rheumatoid arthritis should be monitored regularly, as effective management of these diseases reduces the risk of recurrence. Finally, rigorous skin hygiene helps reduce the risk of transcutaneous infection.

Medical advice should be sought as soon as swelling appears in the elbow, especially if it is painful, red, or warm. The onset of fever, chills, or limited joint movement requires prompt evaluation, as these signs may indicate an infection of the bursa.

Similarly, a recurrent episode or one that persists for more than a few weeks despite treatment should raise alarm bells. A differential diagnosis should be considered in the event of atypical progressive abnormalities.

At Hôpital de La Tour, olecranon bursitis is treated using a personalized, multidisciplinary approach. The orthopedics department works closely with internal medicine and emergency services to provide rapid diagnosis and treatment tailored to each individual case.

The hospital has a full range of technical facilities for carrying out the necessary examinations (X-rays, ultrasounds, MRIs if needed), as well as facilities for punctures and surgical procedures. In cases of infectious bursitis, infectious disease specialists provide targeted antibiotic treatment.

Follow-up care in sports medicine or functional rehabilitation may also be offered to prevent recurrence in at-risk patients, particularly athletes or manual laborers.

What are the first signs of elbow bursitis?
Visible swelling at the tip of the elbow, sometimes accompanied by pain when pressed. In infectious forms, the skin may be red, warm, and fever may be present.

Is olecranon bursitis dangerous?
Most cases are benign. However, if the infection is left untreated, serious complications can arise.

How can elbow bursitis be relieved?
Rest, ice, elevation of the limb, and non-steroidal anti-inflammatory drugs. Compression with an elastic bandage can help reduce swelling.

When should you see a doctor?
As soon as you notice pain, swelling, or redness in the elbow, especially if accompanied by fever or discharge.

Can olecranon bursitis be prevented?
Yes. Avoid prolonged pressure on the elbows, wear protective gear during risky activities, and manage chronic inflammatory diseases effectively.

Does olecranon bursitis require surgery?
Surgery is reserved for recurrent or infectious forms that are resistant to medical treatment. It involves removing the inflamed bursa.

What is the role of puncture in bursitis?
It relieves pain, allows the fluid to be analyzed, and guides treatment, particularly in cases of suspected infection or gout.

Does bursitis often recur?
It can recur in the absence of prevention, especially in patients exposed to microtrauma or suffering from chronic diseases.