Elbow bursitis
Elbow bursitis is an inflammatory process that has arisen in the tissues surrounding the olecranon. In order to understand what we are talking about, you should know that around any joint, including the elbow, there are synovial bags filled with a small amount of fluid, which are called bursa in Latin. In a normal state, they serve the same role as lubricants in an engine, that is, they prevent joints from rubbing against each other when moving. Therefore, they are not injured as a result of natural human activities.
If we consider specifically the elbow joint, then it is surrounded by three bursa:
- Interosseous
- Ulnar subcutaneous
- Interosseous ulnar
Each of them contains a certain amount of fluid, which normally performs its function, so a person does not experience painful sensations when moving his hands. But sometimes, for a number of reasons, inflammation occurs in the cavity of one or several synovial bags at once, the fluid begins to arrive, its composition changes, the elbow becomes painful. It is this condition that is called bursitis of the elbow joint.
Doctors classify bursitis according to several parameters:
- Depending on the location (by the name of the synovial bags).
- By the nature of the course of inflammation - acute, subacute or chronic type.
- Depending on the composition of the fluid (exudate) that accumulates in the synovial bag - purulent, serous, fibrous, hemorrhagic.
- If bursitis is caused by any microorganism, then it may have the name nonspecific (microorganisms from the group of streptococci and staphylococci) or specific (for example, caused by gonococci, spirochete pallidum, tuberculosis or syphilitic bacteria).
Inflammation of this slit-like formation precisely on the elbow is a fairly common phenomenon and is in second place after inflammation of the shoulder joint.
Content:
- Elbow bursitis causes
- Elbow bursitis symptoms
- Purulent bursitis of the elbow joint
- How is elbow bursitis treated?
Elbow bursitis causes
Bursitis of the elbow joint can occur for a number of reasons, among which it is customary to distinguish the following:
- In the first place, as a factor leading to the development of bursitis, is arthritis of any nature - psoriatic, rheumatoid or gouty. That is, against the background of acute inflammation in the cartilage itself or in the synovial bag, fluid begins to accumulate, which leads to the formation of bursitis.
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Bursitis can be a consequence of the resulting microtrauma, but this is less common. The elbow is injured due to constantly repetitive monotonous movements, therefore this disease is unofficially called "professional" illness of all those people whose activities are related to the support of the elbow on a hard surface. These can be students, engravers, chess players, draftsmen, etc. In such people, the subcutaneous ulnar bag is most often inflamed, and, for example, in tennis players, the interosseous ulnar. This difference is due to the peculiarities of the distribution of the load on the elbow, and hence the place of occurrence of microtraumas.
- Sometimes bursitis occurs some time after receiving a mechanical injury to the elbow. In the event that a person hits or falls on this part of the body.
- Bursitis can also occur as a result of infection. This happens especially often when the skin tissue was damaged directly next to the bursa, and a certain microorganism or bacterium got inside. Panaritium can also serve as an infectious cause of bursitis, when the bones and soft tissues of the fingers are exposed to acute inflammation. Also, the infection can get into the synovial bag not from the outside, but "from the inside", that is, it can be transferred through the blood (hematogenous pathway) and through the lymph (lymphogenous pathway).
- It is extremely rare, however, that idiopathic inflammation of the bursa occurs, that is, the etiological causes of which remain unclear.
Another risk factor leading to inflammation in the elbow joint is some chronic diseases such as diabetes. The cause of suppuration can also be a general weakening of the immune system, metabolic disorders, as well as taking steroid drugs.
Elbow bursitis symptoms
The main symptoms of elbow bursitis are the following:
- The appearance of puffiness in the relevant area. Sometimes it can occur for no apparent reason, be absolutely painless and not interfere with the free movement of the hand.
- If you leave the swelling unattended, then over time it will become much more noticeable, significantly increase in volume and a feeling of discomfort and pain will appear.
- Often there is reddening of the skin around the elbow and its sharp filling.
- A person may have a rise in body temperature, up to the onset of febrile conditions. With a similar course of bursitis, severe pain occurs in the elbow region and the general condition deteriorates sharply.
- Concomitant symptoms of intoxication occur, which are characterized by headaches, general weakness, sweating, apathy and loss of appetite.
- From the moment the joint capsule grows in size, the mobility of the hand becomes somewhat limited, when you try to bend the hand, pain occurs.
- If you continue to ignore this condition and leave the elbow bursitis without appropriate therapy, then it will turn into a purulent form, and fistulas that protrude outward and subcutaneous phlegmon will appear at the site of inflammation.
- Swollen lymph nodes.
Depending on the form of bursitis, the accompanying symptoms will also differ:
- Acute serous inflammation of the bursa is characterized by swelling, slight pain and increased skin temperature in the area of edema. The general condition is disturbed not too pronounced.
- If serous bursitis is not treated, then it may either disappear on its own or become chronic. With her, pains not even during the period of exacerbation will continue to bother a person, especially during physical exertion, the movement of the elbow is somewhat limited, upon palpation, doctors detect a fluctuating formation, which can be both elastic and loose. If bursitis has been chronic for quite a long time, then several seals can be found. Chronic bursitis is often prone to relapse.
- If the bursitis is purulent, then the painful sensations do not cease to bother the patient, they are twitching or bursting. The elbow itself becomes bright red, hot to the touch. The general condition of a person is disturbed.
If any of these symptoms occur, you should not try to diagnose yourself, let alone start treatment. After all, the signs of bursitis are quite similar to those of arthritis, gout or polyarthritis. In each case, a variety of treatments are required, with the use of different drugs. Therefore, if there is a suspicion of bursitis, it is worth bandaging the elbow with an immobilizing bandage, providing him with peace and going to the orthopedic department to the appropriate specialist.
Purulent bursitis of the elbow joint
Purulent bursitis is characterized by the formation of purulent contents in the articular bursa of the elbow. It is caused by bacterial infections of this cavity.
Most often, purulent bursitis of the elbow is caused by streptococci and staphylococci, which penetrate into the bag as a result of mechanical injury to the skin in the corresponding area. It may even be a small scratch or abrasion, but if it damages the synovial bag, then in almost 100% of cases it leads to the formation of bursitis, which, in the absence of specialized therapy, becomes purulent over time. The presence of pustular formations on the skin next to the elbow joint or directly on it will lead to early infection and suppuration.
But sometimes microtraumas caused by professional activities can lead to the formation of purulent inflammation.
Symptoms of purulent bursitis are characteristic of any inflammatory process, the swelling is located at the top of the elbow and, depending on the severity of the disease, can have different sizes. The pain is intense, the skin is red and hot to the touch, the human body is weakened, the body temperature rises to high values.
If a purulent nature of the disease is suspected, a blood sample is taken from the patient for a general analysis and to establish the sugar level, and it is also necessary to collect urine. If necessary, doctors can prescribe an ultrasound scan and take a puncture to establish the nature of the contents, but as a rule, such manipulations are rarely required.
Purulent bursitis should be distinguished from similar arthritis. With the last hand movement, it is almost impossible to make, the pain is felt directly inside the joint itself.
For treatment, surgical intervention is necessary in order for the pus to come out. After that, the excised surface is treated with antiseptics and a sterile bandage is applied. Healing is often slow and reoperation is required.
In this case, the following complications may arise:
- Phlegmon muscular and subcutaneous.
- Purulent arthritis, when the whole joint is involved in the process.
- Inflammation of the lymph nodes or cutaneous ducts (lymphadenitis and lymphangitis).
Prevention includes the elimination of traumatic situations and timely treatment of the onset of the inflammatory process.
How is elbow bursitis treated?
If bursitis is not complicated and is the result of a slight injury, then it can go away on its own, with limitation of the mobility of the sore spot and the imposition of a cold compress, followed by the use of Dimexide as a resorbing agent.
In all other cases, qualified medical attention is required. To begin with, the doctor prescribes non-steroidal anti-inflammatory drugs, for example, ibuprofen in combination with nimesulide and diclofenac. If the cause of the development of inflammation is a bacterium, then antibiotics are needed. In the absence of effect and with significant accumulation of fluid, it is necessary to perform a puncture. With its help, fluid is aspirated, which almost instantly helps to relieve pain symptoms and significantly reduces pressure on adjacent tissues. When puncturing, depending on the indications, either antibiotics or steroid drugs are injected inside to relieve inflammation.
Elbow bursitis surgery
Surgical intervention is carried out only in extreme cases, when all the tried and tested methods are ineffective. Most often, the operation is needed for recurrent bursitis, or purulent-hemorrhagic inflammation, as well as for persistent serous inflammation.
Bursectomy is a rather traumatic intervention, which subsequently permanently incapacitates the hand, depriving a person of working capacity. That is why surgeons in their practice increasingly began to use the following, no less effective treatment regimen: the operation site is injected, then puncture is performed with a rather thick needle, which allows aspiration of fluid. Then, with the help of special manipulations, a catheter is inserted into the bursa, which has a compressed pear at one end. After that, it gradually unfolds and completely removes all the contents of the bag cavity. Thus, its global excision is not required, and healing takes place in a significantly short time.
Sometimes bursitis requires treatment even in remission. The method of therapy is determined by the doctor, ultrasonic heating and electropharesis are used quite often and very successfully. These procedures help relieve spasms and tension from sore muscles. Cryotherapy is used to relieve puffiness. After the main symptoms have been eliminated, massage and paraffin applications may be prescribed.
Author of the article: Kaplan Alexander Sergeevich | Orthopedist
Education: diploma in the specialty "General Medicine" received in 2009 at the Medical Academy. I. M. Sechenov. In 2012 completed postgraduate studies in Traumatology and Orthopedics at the City Clinical Hospital named after Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery.
