- Incidence: 500.00 cases per 100,000 person-years
- Peak incidence: 30-40 years
- Sex ratio: more common in males 1.5:1
- Repetitive trauma (29%) - writers and students leaning on elbows, plumbers, miners
- Direct trauma (17%)
- Infection (33%) - 50% of cases occur in immunosuppressed patients (alcohol abuse, diabetes, taking steroids, renal failure, malignancy). 90% of cases due to Staphylococcus aureus.
- Gout (7%)
- Rheumatoid arthritis (5%)
- Idiopathic (5%)
- swelling over the olecranon process (100%)
- tenderness over the bursa (45%)
- erythema over the bursa (25%)
-tenderness over the bursa (92-100%)
- Swelling over the posterior aspect of the elbow, usually fluctuant and well-circumscribed, appearing over hours to days4
- Tenderness on palpation of the swollen area
- Redness and warmth of the overlying skin
- Skin abrasion overlying the bursa
- Effusions in other joints if associated with rheumatoid arthritis
- Tophi if associated with gout
Movement at the elbow joint should be painless until the swollen bursa is compressed in full flexion.
- Not always needed if a clinical diagnosis can be made and there is no concern about septic arthritis, e.g. a well patient without pain, fever or erythema of the bursa.
- Aspiration of bursal fluid for microscopy (Gram stain and crystals) and culture is essential if septic bursitis is considered. Purulent fluid suggests infection whereas straw-coloured bursal fluid favours a non-infective cause.