Olecranon bursitis is a painful swelling that develops at the back of the elbow due to inflammation of the bursa, the thin sac of fluid that lies between the bony tip of the elbow (olecranon) and the skin. Normally, this sac only has a tiny bit of fluid inside of it to help the skin slide smoothly over the bone. However, the bursa can become irritated or inflamed and fill with extra fluid.
In many cases, the cause of the olecranon bursitis is unknown. Trauma, such as hitting the elbow or falling on the back of the elbow, can sometimes lead to olecranon bursitis. People who lean their elbows against hard surfaces can develop this problem over time. Those with conditions such as gout, rheumatoid arthritis, or kidney failure needing dialysis can be more likely to get olecranon bursitis.
Gradual swelling at the back of the elbow might not be noticed at first. However, sometimes the swelling develops quickly and can enlarge to the size of a golf ball at the tip of the elbow. If the bursa remains uninfected, it may not cause pain. Once infected, you will experience tenderness, redness, or warmth in the area. In some instances, a fever may develop. Left untreated, an infected bursa can break open and drain pus.
To make a diagnosis and treatment plan, your doctor may order an x-ray to look for a broken bone, bone spur, or calcium deposit at the elbow to identify possible causes of irritation. Blood tests can check for infection or another cause, such as gout or rheumatoid arthritis and some fluid might be removed from the bursa with a needle to test for pus, which would indicate infection.
If the bursa does not seem to be infected, avoiding activities that are irritating the area, applying a snug elbow wrap or elbow pads, and/or taking oral anti-inflammatory medications can help resolve the condition. Your doctor might also choose to remove the fluid from the bursa first with a needle (aspiration). Sometimes a steroid injection is also placed into the site. If the bursa is infected, antibiotics might be needed. Sometimes the bursa has to be removed with surgery if the infection cannot be cleared, or if the bursitis becomes a chronic problem.