What is the ulnar bursa and why does it become inflamed?
The olecranon bursa is a thin sac between the skin and bone, normally with almost no fluid. It relieves pressure when a person leans on his elbow. Constant support on a hard table, work with emphasis on the elbows, bumps and falls irritate the walls of the bag, and it begins to produce excess fluid. If bacteria enter through an abrasion or puncture, purulent bursitis develops. People with gout may have uric acid crystals deposited in their bursa.
- Chronic support on the elbows in drivers, students, office workers
- Repeated blows and falls on the elbow
- Penetration of infection through an abrasion
- Gout and Crystal Deposition
- Rheumatoid arthritis and other arthritis
- Diabetes mellitus and reduced immunity
Symptoms
The main symptom is a rounded swelling on the back of the elbow, soft to the touch, sometimes almost painless. Movements in the joint itself are often preserved because the bursa is inflamed, not the joint. When infected, the picture changes: the skin turns red, becomes hot, throbbing pain, fever and weakness appear. Sometimes bursitis develops gradually and a person notices the bump by accident.
- Soft mobile swelling above the olecranon process
- Feeling of iridescent fluid under the skin
- Pain when leaning on the elbow
- Flexion and extension are often not limited
- With suppuration - redness, heat, temperature
What is the difference between purulent bursitis?
It is important to distinguish between forms because treatment approaches are different. With aseptic bursitis, the skin is of normal color or slightly pink, body temperature is normal, and pain is moderate. With purulent pain, the pain is sharp and constant, the skin is bright red and hot, the entrance gate of infection is often visible - an abrasion or scratch. A puncture confirms the diagnosis: when suppuration occurs, a cloudy liquid is obtained, which is sent for culture. In blood tests, white blood cells and C-reactive protein increase.
- Aseptic - no heat or bright redness
- Purulent - sharp pain, redness, temperature
- Puncture and fluid culture solve the problem
- Leukocytosis and high C-reactive protein during infection
- In case of gout, crystals are found in the fluid
Diagnostics
An inspection is usually sufficient. An ultrasound confirms the accumulation of fluid in the bursa, shows the thickness of the walls and the presence of septa, and helps to distinguish bursitis from hygroma, lipoma and gouty node. An X-ray is needed if there has been an injury or there is a suspicion of a bone spur, fracture or calcifications. If there are signs of infection, a puncture with culture is performed and blood tests are taken. If bursitis recurs for no apparent reason, uric acid and rheumatoid factor are checked.
- Examination by an orthopedist-traumatologist
- Ultrasound of the ulnar bursa
- X-ray of the elbow joint in two projections
- Puncture of the bursa with culture for suspected pus
- Complete blood count and C-reactive protein
- Uric acid and rheumatoid factor in repetitions
Treatment and prevention
For aseptic bursitis, the main thing is to remove the load: do not lean on the elbow, use a soft pad, put on an elastic bandage for several days. Cold in the first days and anti-inflammatory drugs help. A puncture is performed on a large, tense bursa to facilitate and clarify the diagnosis, sometimes followed by the administration of a drug. For purulent bursitis, antibiotics and often drainage are needed. Chronic bursitis with a dense thickened bursa sometimes requires its removal. The treatment regimen is determined by the doctor.
- Eliminate support on the elbow, protective pad
- Cold in the first days, then dry heat as directed
- Nonsteroidal anti-inflammatory drugs
- Puncture with fluid removal
- Antibiotics for infections - only as prescribed by a doctor
- Removal of the bursa in case of persistent chronic course