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Elbow bursitis Wikipedia

27 Aug 18

Bursitis of the elbow joint - symptoms and treatment, causes

Bursitis of the elbow joint very often occurs at a young age, it is called student or sports bursitis. Uneven distribution of the load or forced long-term position of the elbow joints in a stationary position leads to an inflammatory process.

Like all joints, the elbow has articular capsules, the inflammation of which leads to bursitis. Symptoms are more common in men. Synovial fluid is normally sterile and washes the articular surface in sufficient quantity for smooth sliding of the surfaces within the joint itself.

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There are many causes of bursitis and it is quite difficult to determine one main cause. It is necessary to undergo a course of examination to clarify the diagnosis and further treatment. The main reasons include the following:

  • Injuries;
  • Hypothermia;
  • Staying in one position for a long time (students);
  • Work in difficult conditions (miners);
  • Uneven loads on joints (athletes);
  • Infectious diseases;
  • Disruption of the endocrine system;
  • Failure in the metabolic process (obesity);
  • Aggravated allergic background.
  • Elbow bursitis due to the condition of the synovial fluid can be:

    1. Serous, inflammatory process without complications.
    2. Hemorrhagic, with blood effusion into the joint fluid.
    3. Purulent, infectious bursitis with complications.

    Depending on the time of origin and the nature of the pathological process, inflammation of the elbow joint can be:

    Symptoms and course of the inflammatory process

    The first symptoms of the pathological process begin with swelling of the elbow joint, manifesting gradually or sharply increasing during acute bursitis. Restriction of joint movements and the occurrence of pain in the elbow.

    Increased body temperature and local focal temperature due to increased inflammatory process. Redness of the skin and increased volume of the joint membranes of the elbow.

    Bursitis of the elbow joint can become complicated if infectious pathogens join the inflammatory process. For example:

    Suppurative processes can move from the membranes into the elbow joint itself. Degenerative changes in cartilage tissue and bones may occur, in some cases the formation of fistulas in bone tissue. Phlegmonous inflammation of surrounding tissues can also cause a complication.

    Chronic indolent bursitis of the elbow joint has no clinical symptoms. It can only be detected by tactile examination or by increasing the load on the elbow. At a young age, even in the presence of chronic bursitis, there are no manifestations as such. The inflammatory process can develop over a long period of time, without obvious changes or pain.

    There is no one specific examination method for making a diagnosis. This disease is detected through a comprehensive examination, which includes the following types of diagnostics:

  • Examination by a doctor of the relevant specialty;
  • Taking anamnesis;
  • X-ray examination;
  • Ultrasound examination;
  • Laboratory tests (blood, urine);
  • Thermal indicator;
  • MRI;
  • Puncture of the elbow joint.
  • Even “advanced” joint problems can be cured at home! Just remember to apply this once a day.

    Symptoms of bursitis at a young age are practically not observed. A full comprehensive examination is carried out to determine the exact causes of the pathological process, make a diagnosis and prescribe a course of treatment.

    After a complete examination and diagnosis by the doctor, an individual treatment plan for the patient is drawn up. Depending on the patient’s condition and the neglect of the pathological process, therapeutic measures are prescribed:

  • Therapeutic treatment (the patient is at home).
  • Day hospital.
  • Complete inpatient treatment.
  • Symptoms of bursitis may increase during the acute period of the disease, and at this stage hospital treatment is recommended. The treatment process includes the following:

  • Complete absence of load on the elbow joint;
  • Medications;
  • Physiological therapy.
  • Treatment of elbow bursitis begins with medication. Various drugs are used in combination:

  • If there is an infectious onset, use antibacterial drugs.
  • Medicines that relieve the inflammatory process (injections, tablets, ointments, gels, compresses).
  • Symptomatic medications (vitamins, drugs that improve blood circulation).
  • Physiological therapy

    After the acute period of bursitis has passed, physiotherapy is added to the complex of treatment procedures. Painful symptoms subside during the first procedures. Physiological procedures are well tolerated by patients, such as:

  • UHF;
  • Massage;
  • Laser therapy;
  • Paraffin heating;
  • Mud treatment;
  • Magnetotherapy;
  • Bishofite wraps;
  • Physiotherapy.
  • It is recommended to treat elbow bursitis at home by following a certain diet. It is recommended to limit the use of table salt in food and reduce the consumption of meat broths, however, boiled meat is beneficial. It is advisable to consume fruits and vegetables according to the dietary menu.

    Possible complications

    With complications of acute or chronic bursitis, a suppurative process may occur in the joint capsule with the possibility of entering the joint. In this case, a puncture or operation is prescribed, performed exclusively in a surgical hospital. The elbow joint is cleaned and washed to prevent pathological degenerative changes.

    Elbow bursitis can recur for several reasons:

    • The full course of treatment has not been completed (usually, as pain subsides, patients often stop the treatment process);
    • Failure to comply with the rules of the rehabilitation period;
    • Return to external loads on the elbow joint (sports, hard work);
    • Systemic diseases (arthrosis, endocrine problems).
    • Disease prevention

      Only a doctor can tell you how to treat elbow bursitis and take preventive measures. During periods of remission, you can additionally take herbal teas, decoctions and use plant-based ointments.

      With timely treatment and implementation of all complex treatment measures, the outcome of the disease is favorable. Prevention of the disease can be the correct mode of work and rest, absence of stress on the elbow, balanced nutrition, and timely treatment of infectious diseases.

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      Bursitis of the elbow joint, the treatment of which in modern conditions is quite simple, but you should carefully monitor changes in your body in order to identify health problems in time.

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        1. Small medical encyclopedia. — M.: Medical encyclopedia. 1991–96 2. First aid. - M.: Great Russian Encyclopedia. 1994 3. Encyclopedic Dictionary of Medical Terms. - M.: Soviet Encyclopedia. — 1982—1984

        See what “bursitis” is in other dictionaries:

        BURSITIS - (from the Greek bursa bursa), inflammation of the mucous bursae, both permanent and newly formed, over bony protrusions, where there is constant pressure or friction. B. is caused by traumatic injuries (bruises), repeated mechanical... ... Big Medical Encyclopedia

        BURSITIS - inflammation of the periarticular mucous bursae due to repeated bruises, friction, infection, etc. ... Big Encyclopedic Dictionary

        Bursitis - (from Late Lat. bursa bursa * a. burcite; n. Butsitis; f. bourcite; i. burcita) a disease associated with inflammation of the mucous bursae primarily. in the area of ​​the joints. B. prof. character develop as a result of chronic joint injuries (for example ... Geological Encyclopedia

        bursitis - noun, number of synonyms: 4 • achillobursitis (2) • inflammation (320) • disease (339) ... Dictionary of synonyms

        bursitis - burcite Bursitis in the inflammation of mucus bursae near the suglob. Accompanying the movement of creations and accumulations in their empty deposits. Caused by injuries, acute and chronic infections, and diabetes. Bursitis is often associated with... ...Girnichy Encyclopedic Dictionary

        BURSITIS - honey. Bursitis is an acute or chronic inflammation of the synovial bursa. A syndrome characteristic of many conditions. Synovial bursae are represented by sac-like cavities with synovial fluid, located in places exposed to mechanical... ... Reference book on diseases

        BURSITIS - (from the Latin bursa bursa), inflammation of the synovial bursa, a small fluid-filled connective tissue sac, or pocket, usually located in places of greatest friction of tendons or muscles on the bone. Synovial bursae can also... ... Collier's Encyclopedia

        The elbow joint , articulatio cubiti, is formed by the articular surface of the distal epiphysis of the humerus - its trochlea and the head of the condyle, the articular surfaces on the ulna - the trochlear and radial notches of the ulna, as well as the head and articular circumference of the radius. The joint is complex (articulatio composita), as it consists of three joints, each of them having its own shape.

        In the cavity of the elbow joint there are three joints: the humeroulnar, brachioradial and proximal radioulnar.

        1. The humeroulnar joint, articulutio humeroulnaris, is located between the surface of the trochlea of ​​the humerus and the trochlear notch of the ulna. It is a uniaxial joint and is a trochlear joint, having a helical deviation of the articular surfaces.

        3. The proximal radioulnar joint, articulatio radioulnaris proximalis, lies between the radial notch of the ulna and the articular circumference of the head of the radius: it is a typical cylindrical joint with rotation around one vertical axis.

        1. Ulnar collateral ligament, lig. collaterale ulnare, goes from the base of the medial epicondyle of the humerus down and, expanding in a fan-shaped manner, is attached to the edge of the trochlear notch of the ulna.

        2. Radial collateral ligament, lig. collaterale radiale, starts from the base of the lateral condyle of the humerus, follows down to the outer surface of the head of the radius, where it divides into two bundles. These bundles take a horizontal direction and, bending around the head of the radius in front and behind, are attached to the edges of the radial notch of the ulna. The superficial layers of the ligament fuse with the extensor tendons. the deep ones pass into the annular ligament of the radius.

        3. Annular ligament of the radius, lig. anulare radii, covers the articular circumference of the head of the radius from the anterior, posterior and lateral sides and, attaching to the anterior and posterior edges of the radial notch of the ulna, holds the radius at the ulna.

        4. Square ligament, lig. quadratum are bundles of fibers that connect the distal edge of the radial notch of the ulna to the neck of the radius.

        There are no lateral movements in the elbow joint, as they are inhibited by strong collateral ligaments. In general, the elbow joint is a trochlear joint with a somewhat helical sliding shape of the articular surfaces.

        In addition to the annular ligament of the radius, the interosseous membrane of the forearm takes part in fixing the bones of the forearm.

        The interosseous membrane of the forearm, membrana interossea antebrachii, fills the gap between the radius and ulna bones, attaching to their interosseous edges and forming the radioulnar syndesmosis, syndesmosis radioulnaris.

        It is formed by strong fibrous bundles that run obliquely from top to bottom from the radius to the ulna. One of these bundles has the opposite direction: it follows from the tuberosity of the ulna to the tuberosity of the radius and is called the oblique chord, chorda obliqua. The membrane has holes through which blood vessels and nerves pass. A number of muscles of the forearm begin from its palmar and dorsal surfaces.

        Atlas of Human Anatomy. Akademik.ru. 2011.

        Treatment of purulent bursitis of the elbow joint - surgery, antibiotics and other treatment methods

        What you need to know about elbow bursitis?

        Purulent bursitis of the elbow is painful, often with a sharp increase in temperature. Among traumatologists, the occurrence of suppuration in the elbow is considered a consequence of unprofessional medical care provided in the first days of the disease.

        People at risk for developing elbow bursitis include:

      • persons whose professional activities involve increased physical stress on their hands and, in particular, elbows (school and university students, seamstresses, draftsmen, engravers, etc.);
      • persons working with chemical reagents;
      • athletes;
      • patients with systemic diseases, suffering from diabetes, rheumatism, psoriasis, gout, etc.;
      • patients with skin diseases (erysipelas, pyoderma) with ulcers localized in the elbow area;
      • persons with reduced immunity.

      Causes and features of the development of infections in the bursae of the elbow

      Purulent inflammation of the bursa usually develops soon after a mechanical injury or in the case of chronic infection of the patient's body. The cause is the penetration of certain pathogenic bacteria into the joint cavity.

      Such pathogens can be:

    • with a reduced immune status - staphylococci and streptococci;
    • for systemic infections - enterohemorrhagic Escherichia coli, Pseudomonas aeruginosa;
    • for infections of the reproductive system - chlamydia, gonococci;
    • for specific infectious diseases - spirochete pallidum (syphilis), Koch bacillus (tuberculosis), etc.
    • Interosseous bursae usually become inflamed in the presence of systemic infections. The subcutaneous bursa often becomes infected due to the development of deep skin ulcers.

      Clinical symptoms

      The main symptoms of purulent bursitis of the elbow:

      1. Increasing swelling, redness of the skin on the elbow.
      2. The appearance of pain when moving your hand.
      3. Rise in body temperature to 38° and above.
      4. Development of general intoxication, headache, weakness, sweating.
      5. Limitation of range of motion in the elbow joint.
      6. Enlargement of regional lymph nodes;
      7. The advanced form manifests itself in the appearance of fistulas, subcutaneous phlegmon (diffused purulent inflammation).
      8. A rapid increase in symptoms is typical for older patients.

        See what advanced purulent bursitis of the elbow joint looks like in the photo:

        If such symptoms occur, you should see a surgeon at the clinic or, if the patient’s condition is serious, call an ambulance to hospitalize the patient in the surgical department.

        Diagnostic measures for suspected purulent ulnar bursitis include:

        1.? Joint puncture followed by bacteriological examination of intra-articular fluid.

        2.? Lab tests:

      9. general blood analysis;
      10. blood sugar test;
      11. general urine analysis.
      12. 3.? Instrumental examination of the joint:

        When the joint becomes suppurated, a puncture is performed. It involves intra-articular injection of a syringe and direct drawing out of pus. During the procedure, an analysis of the exudate (intra-articular fluid) is taken. Then the joint cavity is washed with an antiseptic. It is practiced to install a catheter for drainage of pus.

        Puncture helps relieve pain and promotes rapid healing, especially with subsequent intra-articular administration of antibiotics and corticosteroid hormones.

        Antibacterial drugs (Amoxiclav, Lincomycin, Ceftriaxone, etc.) are then prescribed orally or intramuscularly (intravenously).

        Additionally, therapy with anti-inflammatory drugs (Diclofenac, Nimesulide, Ibuprofen, etc.) is used.

        After the elimination of purulent inflammation, the patient is prescribed physiotherapeutic treatment: UHF, ultrasound, etc. These techniques accelerate the resorption of exudate.

        If the puncture does not lead to an improvement in the patient’s condition, a full-fledged surgical intervention and surgical opening of the joint capsule will be required in a few days. In this case, complete drainage of the bursa is performed with its partial excision or complete removal. Bursectomy is often performed at the stage of phlegmon formation.

        To prevent sepsis, relapse and reduce the affected area, immunomodulatory drugs, antibiotics, and non-steroidal anti-inflammatory drugs are prescribed.

        Recovery after surgery

        Purulent bursitis of the elbow joint requires serious treatment after surgery. If this is not done, purulent arthritis may occur at the site of inflammation. In this case, all joint tissues are involved in the inflammatory process. Subsequently, arthrosis may develop in the affected joint.

        The most effective treatment methods include laser therapy. With its help, you can completely cure the inflammatory process and achieve regeneration of joint tissue.

        In addition, rehabilitation measures include:

      13. prescribing a specific diet to restore bones and joints;
      14. treatment and prevention of chronic infections;
      15. massage with fir oil;
      16. turpentine baths;
      17. rubbing in balms based on bear fat and api-products, etc.
      18. Preventive treatment is carried out at least 2 times a year, in spring and autumn, and additionally as needed.

        Purulent bursitis of the elbow is a serious pathology, conservative treatment of which is possible only in the early stages of its development. If the process has become advanced, only surgical intervention will help. It is also used in cases of ineffectiveness of conservative therapy. The operation is a way to prevent sepsis and the subsequent occurrence of arthritis and arthrosis.

        The elbow is formed by the union of the humerus and the ulna of the forearm. The ulna has a bony protrusion located at the back of the elbow known as the olecranon. This bony protrusion is the attachment point for several muscles, including the triceps, and forms the outermost point of the back of the elbow. Between the olecranon and the overlying skin is the olecranon bursa. The bursa is a small sac filled with liquid - a lubricant and its function is to reduce friction between adjacent layers of soft tissue.

        The triceps muscle is primarily responsible for straightening the elbow and is especially active during pushing activities. During contraction of the triceps, friction is directed towards the ulnar bursa. Pressure on the olecranon bursa can also occur due to a direct blow. When this pressure on the bursa is excessive due to too frequent movements or the application of force, conditions arise for inflammation of the olecranon bursa.

      19. Moderate but repetitive trauma is the most common cause. For example, people who lean on their elbows cause friction and mild trauma to the tissue over the olecranon. For example, there are terms such as “student’s elbow,” plumber’s elbow or miner’s elbow, and these terms are based on prolonged support on the elbows.
      20. Single injuries, such as a blow to the back of the elbow, can cause inflammation.
      21. Arthritis. One or more bursae may become inflamed as a result of polyarthritis (but most cases of olecranon bursitis are not associated with arthritis).
      22. Bursa infection. This can happen if there is a cut in the skin over the bursa that allows bacteria to enter.
      23. Idiopathic. In many cases, bursitis occurs for no apparent reason. However, it is possible that in some cases, bursitis is associated with a minor injury that has been forgotten.
      24. Normally, a person cannot feel or see the bursa. If inflammation of the olecranon bursa occurs, then thickening of the skin and swelling appears on the back of the elbow. The bursa can also be filled with fluid and then appear as a small, soft ball - a bit like a cyst. In most cases (non-infected bursitis and not associated with arthritis), elbow bursitis is painless or slightly painful. Movement in the elbow joint is not impaired.

        If the bursa is infected (“septic” olecranon bursitis), pain, redness, and tenderness in the elbow typically develop.

        Bursitis associated with arthritis may not be painful in itself, but there may be joint pain due to arthritis. Patients with olecranon bursitis usually experience pain and swelling at the back of the elbow. The pain is usually worse when leaning on the elbow or when bending or straightening the elbow. In less severe cases, patients may experience only pain and stiffness in the elbow at rest after activities such as carrying a bag. Additionally, activities such as using a hammer or straightening the elbow against resistance can also cause pain in the initial stages.

        As it progresses, patients may experience symptoms that increase during sports or physical activity. Patients may notice swelling and a large ridge above the ulnar prominence. Most patients with olecranon bursitis experience pain when the olecranon is touched. Sometimes small lumps can be felt in the area of ​​the olecranon. Patients may also experience weakness in the elbow, especially when trying to straighten the elbow against resistance.

        Typically, a physical examination by a doctor is sufficient to make a diagnosis. But in order to exclude the possible presence of infection or arthritis, it is also necessary to conduct laboratory tests and x-rays. In some cases, CT or MRI may be prescribed to exclude the tumor genesis of the formation.

        In most cases, elbow bursitis can heal on its own by reducing the stress on the elbow. But in some cases, medical intervention, including surgery, is required.

        Conservative treatment of elbow bursitis includes:

      25. Rest and change in activity. Patients with elbow bursitis should avoid activities that put pressure on the elbow. Wearing elbow pads can also help protect the elbow bursa from pressure or additional irritation.
      26. Cold. Applying a cold compress to a swollen elbow for 20 minutes two or three times a day can help relieve symptoms and reduce swelling.
      27. Compression. Using an elastic bandage wrapped around the affected joint can help reduce swelling.
      28. Elevation. Elevating the elbow to or above heart level reduces blood flow and thereby reduces inflammation.
      29. Drug treatment. Nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen (such as Advil), naproxen (such as Aleve), and COX-2 inhibitors (such as Celebrex) can reduce swelling and inflammation and relieve pain associated with elbow bursitis.

        Aspiration. Aspiration of the swollen bursa using a needle and syringe relieves the pressure immediately. Aspiration is also done to test the fluid for microbes. (A positive test would indicate septic bursitis).

        Corticosteroid injections. Symptoms of bursitis can be significantly reduced with corticosteroid injections. Corticosteroids are powerful anti-inflammatory drugs, and injecting them directly into the inflamed bursa usually significantly reduces pain and swelling. However, corticosteroid injections have potential side effects such as infections and degeneration of the skin on the elbow. Thus, these injections are usually prescribed for persistent bursitis and other treatment is not effective.

        Antibiotics. Septic olecranon bursitis requires antibiotics. The choice of antibiotic depends on the microorganism that is causing the infection (most often Staphylococcus aureus). For most people with septic bursitis, treatment with antibiotics is quite effective, with some requiring hospitalization and intravenous antibiotics.

        Surgery

        Sometimes chronic bursitis or septic bursitis may require surgery. In a traditional bunionectomy, an incision is made in the elbow and the inflamed bursa is removed. Since the bursa is located under the skin, the elbow joint is not affected during the operation.

        Complications of surgical removal of the bursa may include problems with healing of the skin at the incision site and pain. A few months after the operation, a new bursa usually grows at the site of the removed bursa.

        After surgery, patients are recommended to fix their elbow for some time with a special bandage, holding the arm at an angle of 90 degrees.

        Exercise therapy. After the symptoms of bursitis subside, it is quite effective to prescribe exercise therapy to strengthen muscle tone.

        Most patients with this disease recover and return to normal life within a few weeks. Sometimes, rehabilitation can take much longer (up to several months) in cases where bursitis has been going on for quite a long time. Therefore, early treatment and rehabilitation are necessary to restore normal quality of life.

        Use of materials is permitted provided that an active hyperlink to the permanent page of the article is indicated.

        Russian-English technical dictionary.

        See what “bursitis” is in other dictionaries:

        BURSITIS - Fig. 1. Precarpal bursitis in a cow. Rice. 1. Precarpal bursitis in a cow. bursitis, inflammation of the synovial bursa (bursa). Cattle (Fig. 1) and horses are more often affected. According to the course of B., there are acute and chronic, by nature... ... Veterinary encyclopedic dictionary

        Bursitis - I Bursitis (bursitis; Late Lat. bursa bursa + itis) inflammation of the synovial bursa with accumulation of exudate in its cavity. The causes of B. are often injuries (bruises and chronic microtrauma), less often infections, metabolic disorders ... Medical encyclopedia

        bursitis - a; m. A disease characterized by inflammation of the mucous membrane of the joint bursa. Chronic, acute b. B. knee, elbow joint. * * * bursitis - inflammation of the periarticular mucous bursae due to repeated bruises, friction, infection, etc. *... ... Encyclopedic Dictionary

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