Aspiration of the olecranon bursa

Anatomy

The elbow joint is where the upper arm bone (humerus) meets the two forearm bones (radius and ulna). The bony point of the elbow is the olecranon, located at the upper end of the ulna. The elbow consists of several muscles, ligaments, nerves, and tendons, and is both a pivot and hinge joint, meaning it allows you to bend and straighten, as well as twist and rotate your arm. The olecranon bursa is positioned directly under the elbow skin and has very little protection from muscles or other soft tissues.

The olecranon bursa is a thin, fluid-filled sac located at the bony tip of the elbow (olecranon). This sac allows the soft tissues to move freely over the underlying bone.

About the procedure

Aspiration of the olecranon bursa is a nonsurgical procedure used to remove fluid from the olecranon bursa. Normally the olecranon bursa is flat. If it becomes irritated or inflamed, more fluid will accumulate in the bursa, causing it to swell, and that fluid may need to be drained to prevent any further injury in the elbow. This condition is known as elbow bursitis.

Several factors can cause elbow bursitis, including:

• Trauma – A hard blow to the tip of the elbow can cause the bursa to produce excess fluid and swell.
• Infection – If an injury at the tip of the elbow breaks the skin, such as an insect bite, scrape, or puncture wound, bacteria may get inside the bursa sac and cause an infection. The infected bursa produces fluid, redness, swelling, and pain. If the infection goes untreated, the fluid may turn to pus.
• Prolonged pressure – Leaning on the tip of the elbow for long periods on hard surfaces, such as a tabletop, may cause the bursa to swell and fill with fluid.
• Medical conditions – Certain conditions, such as rheumatoid arthritis and gout, are associated with elbow bursitis.

Treatment

If your Florida Orthopaedic Institute physician thinks that your elbow bursitis is caused by an infection, they may recommend an aspiration of the olecranon bursa. This is commonly done as an office procedure with a needle. Fluid removal not only helps to decrease swelling of the olecranon bursa, but will also give your physician a sample of the fluid that can be looked at in a laboratory to identify if any bacteria are present. This lets your physician know if a specific antibiotic is needed to fight the infection.

Depending on the severity of the infection, your physician may prescribe antibiotics to prevent the infection from getting any worse.

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