---

Olecranon Bursits - O2.1

Definition of Condition: Olecranon bursitis is an inflammation of the bursa overlying the olecranon process.

Issue Statement: The evidence for occupational risk factors (especially repetitive activities) producing elbow disorders is limited. A careful history of the job tasks, load, posture and range of movements is needed to assess the degree of cumulative trauma and work related injury.

WCB-Alberta position

Work relationship criteria

For an acute injury, a clear history of direct trauma to the olecranon is needed.  It may also be chronic due to repeated trauma or prolonged pressure to the area.

Clinical criteria

Onset generally insidious, although may develop from an episode of acute trauma. Signs and symptoms may include pain, tenderness and swelling over the olecranon process.  Rarely there is limitation of flexion and extension of the elbow due to pain or swelling of the olecranon bursa.

Signs include:

• a swollen olecranon bursa
• tenderness over the bursa
• with septic bursitis, redness and heat over the bursa and a purulent tap

Diagnostic criteria

Lab tests

• not indicated unless a systemic disorder is suspected, or
• if bursa incised and drained, lab analysis for infection is indicated. 

Imaging Studies

• plain films only to rule out fractures following significant trauma

Electrophysiologic, Strength and Flexibility Tests

• not indicated

Differential diagnosis

Rule out other conditions such as ulnar nerve entrapment, radial nerve entrapment, epicondylitis, rheumatoid arthritis, gout, crystalline pyrophosphate disease (CPPD), and arthropathies.

Recommended management

Education

The primary treating physician should discuss the following in depth with the patient:

• anatomy, natural history, and prognosis
• expected progress with treatment
• proper use of medication
• risk factor modification: avoidance of repeated trauma

Prevention of recurrence

Prevention of recurrence may include:

• education as to preventive measures
• avoidance of conditions predisposing to a recurrence
• education related to home, social and sports activity as well as the work environment

Physical methods of treatment

Physical therapy

• ice for acute non-infectious episodes

Post surgical rehabilitation/reconditioning may be required if I & D or a bursectomy is performed.

Other treatments

• protective padding over olecranon

Medical treatment

Medication

• ASA, acetaminophen, or NSAID may be used as needed for pain relief x 1-2 weeks (maximum)
• local corticosteroid injection for non-responsive non-infectious bursitis may be warranted; no more than 3 should be given within a 9 month period
• antibiotics if becomes infected

If condition has not resolved after one month, reconsider etiology of condition.

Surgical

• septic bursitis should be aspirated
• incision and drainage is rarely required
• excision of bursa and olecranon spurs may be required in chronic bursitis

Fitness to work criteria

• no absence from work anticipated. Septic bursitis may require 1 - 2 weeks off work.
• 1 - 6 weeks after surgery depending on job duties

Permanent clinical impairment criteria

As a general rule, there is no basis for a PCI award unless there is loss of ROM of the elbow joint

[ back to top ]

---

Web site terms of use | Contact us