Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Olecranon Bursitis

SYMPTOMS

There is gradual or acute onset of localised swelling and inflammatory signs over the olecranon.

AETIOLOGY

It can occur after direct trauma and bleeding, from repetitive stress causing synovial fluid to fill the bursa, ‘student’s elbow’ or pus in the bursa from infected superficial skin wounds.

CLINICAL FINDINGS

Localised tender fluctuating swelling over the olecranon but no effusion of the elbow.

INVESTIGATIONS

This is a clinical diagnosis. X-ray is normal. MRI or ultrasound will confirm the diagnosis. If septic bursitis is suspected tests for infections (temperature, CRP, ESR and bacterial cultures) must be performed.

TREATMENT

If the swelling is caused by a bleeding or temporary over-use this injury responds to conservative treatment including ice and compression and avoiding direct impact. There is seldom any indication for surgery. If it is caused by infection antibiotics and/or open drainage of the bursa should be considered. In chronic cases, surgery may also be indicated for cosmetic reasons.

REFERRALS

Refer to Dr Kevin Yip (+65 9724 1219) senior consultant orthopaedic surgeon to determine the cause of the bursitis.

EXERCISE PRESCRIPTION

Rest, if the cause is infection. Otherwise, most sports could be considered.

EVALUATION OF TREATMENT OUTCOMES

Normal clinical symptoms and signs.

DIFFERENTIAL DIAGNOSES

Soft tissue tumour (MRI can differentiate). Septic arthritis (elbow effusion and painful movement).

PROGNOSIS

Good-Fair. Once the bursa has been affected, it will be more sensitive to further knocks and the bursitis can recur independent of the initial cause.

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