Ultrasound-Guided Cortisone Injections for Olecranon Bursitis

 

Introduction

Olecranon bursitis is a condition characterised by swelling and discomfort at the back of the elbow, specifically over the bony prominence known as the olecranon. The olecranon bursa is a small, fluid-filled sac located at this site that acts as a cushion between the skin and the underlying bone. When inflamed, it can lead to noticeable swelling, pain, and functional limitations.

At Joint Injections, we provide a comprehensive approach for those experiencing this condition, including ultrasound-guided cortisone injections performed by skilled clinicians. This blog explores olecranon bursitis in detail, from the underlying anatomy and pathology to management options, and explains the role of cortisone injections in addressing this condition.

Anatomy of the Olecranon Bursa

The olecranon is the bony prominence of the ulna at the back of the elbow joint. Overlying this bony structure is the olecranon bursa, a thin, lubricated sac that facilitates smooth movement between the skin and the underlying bone during elbow flexion and extension.

Key anatomical points:

  • Olecranon bursa: Positioned between the olecranon process and the overlying skin.
  • Elbow joint: Composed of the humerus, radius, and ulna, allowing flexion, extension, and rotational movements.
  • Supporting structures: Ligaments, tendons, and muscles surrounding the elbow provide stability but may also contribute to stress on the bursa.

Pathology of Olecranon Bursitis

Olecranon bursitis involves inflammation or irritation of the bursa. It can develop due to:

  • Trauma: A direct blow to the elbow can lead to acute bursitis.
  • Repetitive microtrauma: Prolonged pressure (e.g., leaning on elbows) can irritate the bursa.
  • Infection: Known as septic bursitis, requiring prompt medical attention.
  • Underlying conditions: Such as gout or rheumatoid arthritis, which may predispose the bursa to inflammation.

The inflamed bursa may fill with excess fluid, resulting in visible swelling and potential discomfort during activities involving elbow movement or pressure on the area.

Causes and Risk Factors

  • Occupational and lifestyle factors: Activities involving frequent leaning on the elbows (e.g., students, office workers, tradespeople).
  • Sports-related strain: Contact sports or those with frequent falls can contribute to trauma-induced bursitis.
  • Systemic conditions: Crystal deposition diseases and systemic inflammatory conditions.
  • Infections: Skin breaks over the elbow can introduce bacteria into the bursa.

Symptoms of Olecranon Bursitis

  • Swelling: Often the most noticeable sign, with a soft, fluctuant mass over the back of the elbow.
  • Pain or tenderness: May vary in severity and is sometimes absent in non-infectious cases.
  • Limited motion: Usually mild, but discomfort may increase with extreme flexion.
  • Redness and warmth: Particularly in septic bursitis.

Diagnosis of Olecranon Bursitis

A clinician may diagnose olecranon bursitis through:

  • Clinical assessment: Observing swelling, palpation for tenderness, and checking for signs of infection.
  • Imaging:
  • Ultrasound: To confirm fluid within the bursa and rule out other conditions.

Management Options

Management depends on the underlying cause:

  • Activity modification: Reducing pressure on the elbow.
  • Rest and ice: To alleviate symptoms.
  • Injections: Cortisone injections may be considered when symptoms persist despite conservative measures.

Ultrasound-Guided Cortisone Injections

At Joint Injections, we utilise ultrasound-guided cortisone injections for targeted management of olecranon bursitis. Ultrasound enables real-time visualisation of the bursa, ensuring precise placement of medication.

Advantages of Ultrasound Guidance:

  • Accuracy: Ensures delivery to the exact location of the affected bursa.
  • Safety: Minimises risk to nearby structures.
  • Effectiveness: Enhances the likelihood of symptom relief by addressing the source of inflammation directly.

What is Cortisone?

Cortisone is a synthetic corticosteroid known for its anti-inflammatory properties. When introduced into the bursa, it may help reduce swelling and discomfort associated with bursitis.

Mechanism of Action of Cortisone

Cortisone acts by:

  • Suppressing inflammatory mediators: Reducing chemicals responsible for pain and swelling.
  • Decreasing vascular permeability: Minimising fluid accumulation in the bursa.
  • Facilitating rehabilitation: Alleviating symptoms, enabling individuals to engage in preventative strategies and functional activities more effectively.

At Joint Injections, the procedure is performed by experienced clinicians in a controlled environment, prioritising precision and patient comfort.

Why Choose Joint Injections?

  • Specialist Expertise: Our clinicians possess advanced training in musculoskeletal conditions and injection techniques.
  • Personalised Care: Each case is individually assessed to develop an appropriate management plan.
  • Advanced Technology: High-resolution ultrasound equipment ensures optimal procedural accuracy.

Summary

Olecranon bursitis is a condition marked by inflammation of the bursa at the back of the elbow, often resulting from trauma, repetitive pressure, or systemic causes. While many cases can be managed conservatively, ultrasound-guided cortisone injections provide a targeted approach when symptoms persist. At Joint Injections, our clinicians deliver these interventions with precision, ensuring a comprehensive and tailored strategy for managing this condition.

This evidence-informed approach allows individuals to work towards improved elbow function and symptom management through targeted, precise care at Joint Injections.

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