Elbow Pain (cont.)
What are diseases and conditions that can cause
elbow pain, and how are they treated?
Arthritis of the elbow
Inflammation of the elbow joint (arthritis) can occur as a
result of
many systemic forms of arthritis, including rheumatoid
arthritis, gouty
arthritis,
psoriatic arthritis,
ankylosing spondylitis, and
reactive arthritis
(formerly called Reiter's
disease). Generally, they are associated with signs of
inflammation of the
elbow joint, including heat, warmth, swelling, pain,
tenderness, and
decreased range of motion. Range of motion of the elbow is
decreased with
arthritis of the elbow because the swollen joint impedes the
range of
motion. For more information on these conditions, please read
the following articles: Rheumatoid
Arthritis,
Gout,
Psoriatic Arthritis,
Ankylosing Spondylitis,
Reactive Arthritis.
Cellulitis
Inflammation of the skin
related to infection (cellulitis)
commonly occurs as a result of abrasions of the skin. When abrasions or puncture
wounds occur, bacteria on the surface of the skin can invade the deeper layers
of the skin. This causes inflamed skin characterized by heat, redness, warmth,
and swelling. The most common bacteria that cause cellulitis include
Staphylococcus and Streptococcus. Patients can have an associated low-grade
fever. Cellulitis generally requires
antibiotic
treatment, either orally or intravenously. Heat application can
help in
the healing process. Cellulitis can lead to infection of the olecranon bursa, causing olecranon bursitis, as described above.
Infected elbow joint (septic arthritis)
Infection of the elbow joint with bacteria (septic arthritis)
is
uncommon. It is most often seen in patients with suppressed
immune systems
or diabetes, those taking cortisone medications, or intravenous
drug
abusers. The most common bacteria that cause infection of the
elbow joint
are Staphylococcus and Streptococcus. Septic arthritis of the
elbow
requires antibiotic treatment and often surgical drainage. It is
characterized by heat, swelling, warmth, redness, and pain,
with limited
range of motion of the elbow joint. Septic arthritis is often associated with
fever,
sweats, and chills.
Tumors
Bone tumors of the elbow joint are rare. Primary bone cancer
can occur.
It can be painless or associated with pain in the elbow joint.
It is
usually detectable by x-ray testing. Nuclear medicine bone
scanning can
also be helpful for detection.
Ulnar nerve entrapment
The ulnar nerve is the "funny bone" nerve which
travels
between the tip of the elbow and the inner elbow bone. At this
site it can
be "pinched" by normal structures or swollen
structures after
injury. This pinching is referred to as entrapment. When ulnar
nerve
entrapment occurs, numbness and tingling of the little and ring
finger of
the hand may be felt. Pain may occur in the entire forearm,
usually the
inner side. Hand dexterity can be affected. Sometimes, the
numbness is
reproduced by elevating the hand. Treatment consists of
avoiding repeated
trauma or pressure to the elbow area and resting the elbow
joint.
Occasionally, ice can help. In severe cases, surgical
repositioning of the
ulnar nerve can be required. This relocates the ulnar nerve to
a position
where it will not be continually compressed by the surrounding
structures.
- The elbow joint is the area of union of three long
bones.
- Tendinitis can affect the inner or outer elbow.
- Treatment of tendinitis includes ice, rest, and
medication for inflammation.
- Bacteria can infect the skin of the scraped (abraded)
elbow.
- The "funny bone" nerve can be irritated at the elbow to cause numbness and tingling of the little and ring fingers.
References:
Koopman, William, et al., eds. Clinical Primer of Rheumatology. Philadelphia: Lippincott Williams & Wilkins, 2003.
Kelley's Textbook of Rheumatology, W B Saunders Co, edited by Shaun Ruddy, et al., 2000.
Last Editorial Review: 3/6/2008
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