To understand what bursitis is in general, and bursitis of the elbow joint in particular, we need for one minute to get distracted by a short course of human anatomy. Around the muscles and joints (that is, where there is constant movement) there are so-called synovial bags (bursa in Latin). Normally, they play the same role as lubricants in the operation of mechanical devices. Due to the small amount of fluid in the cavity of the synovial bag, the friction of the tissues is minimal during movement in the joint and does not have traumatic effects on surrounding tissues.
Bag (bursa) of the elbow joint
Near the elbow joint, there are three bags – brachial, interosseous ulnar and ulnar subcutaneous. They contain a certain amount of fluid, and the functioning of the joint is painless and invisible to all of us. However, in a several cases, inflammation develops in the cavity of the synovial bag, the amount of fluid increases, its character changes, pain symptom joins. In this case, we will talk about bursitis of the elbow joint.
Causes of bursitis and its types
Very often, the cause of bursitis is traumatic. This is especially true for athletes, so bursitis is to some extent considered an occupational disease. For example, in tennis players, bursitis is characterized by localization of the process in the humeral bag (between biceps tendon and radius).
Appearance of a patient with bursitis of the elbow joint
After injury, as a rule, infection of the cavity with pathogenic agents occurs. It can be common staphylococcus or streptococcus (in this case we are talking about nonspecific bursitis), or more exclusive pathogens – tuberculosis, syphilis, brucella, gonococcus. In this case, we are talking about specific bursitis. This is important for choosing treatment tactics.
The nature of exudate (fluid) in the cavity of the synovial bag can also be different: serous (the most harmless option), hemorrhagic (there is blood) and even purulent. Finally, according to the duration of the process, we can divide bursitis into acute, recurrent and chronic.
Symptoms of bursitis
The olecranon bursa is perhaps one of the favorite places for bursitis. This is why bursitis of the elbow joint is more common than other forms.
How does the disease progress, what are the symptoms of bursitis of the elbow joint?
In the area of the inflamed bag (do not forget that there are three of them around the elbow joint, and, therefore, different localisation options are possible), a local compaction and an increase in tissue volume appear. It is impossible to see through the skin that the synovial bag was inflamed, but we can suspect this by a number of characteristic signs.
The consistency of the swelling is soft, the size can reach 7 – 10 centimetres. During palpation, fluctuation in the affected area is determined. Naturally, there is pain and signs of general intoxication, including malaise and fever.
An important difference of bursitis from arthritis of the elbow joint is that the function of the latter is somewhat impaired due to pain, but the range of motion is completely unlimited, as is in the case with arthritis.
If bursitis acquires purulent character, and inflammation begins to spread to surrounding tissues (phlegmonous inflammation), the patient’s well-being worsens significantly, body temperature rises to forty degrees. In this case, hospitalization may be required.
Diagnosis and treatment
The diagnosis can be made already at the external examination of the patient and clarified by puncture of the inflamed bag. The nature of exudate can also be determined and the causative agent of bursitis can be identified. After clarifying the diagnosis, we ask ourselves the question: how to treat bursitis of the elbow joint?
Puncture of olecranon bursa and removal of accumulated fluid
In acute course of the process, you can limit yourself to the following measures: a tight fixating bandage is applied to the joint to prevent further traumatic effects on the bag. The patient is prescribed anti-inflammatory drugs and antibiotics, to which the pathogen of bursitis is sensitive.
It is worth paying attention to the fact that when there is a specific bursitis of the elbow joint, antibiotic treatment will also be specific, and depends on the type of pathogen. In case of resistance to therapy, corticosteroids can be included in the course of treatment, which are injected directly into the bag cavity.
Purulent bursitis of the elbow joint requires a more serious approach to treatment. Such a patient goes to a surgeon, who carries out the puncture of the bag, rinses it and injects antibiotics and corticosteroids directly into the focus of inflammation. Further treatment is continued in compliance with all the principles of purulent surgery, in case of severe forms, it can be carried out in a hospital.
Chronic bursitis of the elbow joint also requires surgical intervention, as this form of the disease creates conditions for frequent relapses of inflammation.