Aetiology

Causes of olecranon bursitis can generally be classified as (1):

• septic
  • seen in one third of presenting cases o usually caused when micro-organisms enter the bursa through soft tissue due to trauma, breaks in the skin or foci of infection (2)
  • occasionally penetration through minute skin breaks could be considered in patients who lack a history of trauma or visible injury (2)
  • 80-90% cases are due to S. aureus (1,2)
  • the following are at risk of developing septic bursitis -
    • people with a history of previous episodes of olecranon bursitis
    • impaired immunity caused by steroids, diabetes, renal impairment, alcohol abuse (2)
• non-septic
  • usually caused by acute trauma, overuse, crystal deposition (e.g. gout), or systemic disease (1)
  • majority occurs in males who are in the age group between 50 to 70 years (3)

People undergoing chronic dialysis are suggested to be at an increased risk of developing olecranon bursitis. Several contributory factors have been put forward:

• persistent pressure on the olecranon bursa through the haemodylasis session
• accumulation of oxalate in the synovium and the skin are thought to contribute to bursitis (3)

Reference:

• 1. Wiler JL. Symptoms: Swollen, Painful Elbow. Emergency Medicine News 2008;30(8):4-12
• 2. Stell IM. Septic and non-septic olecranon bursitis in the accident and emergency department--an approach to management. J Accid Emerg Med. 1996;13(5):351-3
• 3. Roberts JR. Olecranon Bursitis: Etiology and Clinical Characteristics: Part I in a Series. Emergency Medicine News 2002;24:11-22