What is the olecranon bursa?

Aspiration of the olecranon bursa is the drainage by needle of the fluid inside the lubricating fluid sack (bursa) at the tip of the elbow.
Aspiration of the olecranon bursa is the drainage by needle of the fluid inside the lubricating fluid sack (bursa) at the tip of the elbow.

The olecranon is the pointed bone at the tip of the elbow. A bursa is a fluid-filled sac at the tip of the elbow. The bursa helps the skin glide over the bone. 

Normally, this sac has little fluid and lays flat; however, the bursa can become inflamed and fill with extra fluid, resulting in painful swelling at the tip of the elbow.

What is olecranon bursitis?

The inflammation of a bursa, known as olecranon bursitis, can be either infective (septic) or noninfective (aseptic). Aseptic bursitis is the inflammation of the bursa secondary to accidents, crystal deposition and diseases such as rheumatoid arthritis. Septic bursitis is the inflammation of the bursa secondary to infection of the sac with microorganisms.

What is the aspiration of olecranon bursa?

  • Fluid from the olecranon bursa is collected for examination. 
  • Aseptic bursitis can be differentiated from the septic bursitis using the aspiration technique. 
  • The fluid which is drawn via aspiration (aspirate), may have a markedly increased white blood cell (WBC) count, indicating septic bursitis, whereas, only a moderate increase in WBC accompanies aseptic bursitis.

When should be the aspiration of olecranon bursa avoided?

The aspiration of the olecranon bursa should be avoided in the following conditions:

  • Bacteremia (presence of bacteria in the blood)
  • Skin infection at the needle insertion site
  • Joint prosthesis (replacement of joints with an artificial device)

What happens during the aspiration of the olecranon bursa procedure?

  • The physician might give you local anesthesia to numb the area. 
  • You sit upright on a stretcher with your arm resting on a side table, and the elbow bent at 90 degrees.
  • The doctor identifies the inflamed area and selects the elbow site for needle insertion. 
  • Once the site is identified, the doctor applies an antiseptic solution and drapes it.
  • The doctor inserts the needle and advances it into the bursa. 
  • The fluid from the bursa is withdrawn completely. 
  • The needle is retracted and an adhesive bandage is placed on the site.
  • The removal of fluid helps in relieving the painful symptoms as well as provides a sample for examination.
  • After the aspiration is completed, an injection of corticosteroids may be given to reduce inflammation in the elbow.

What are the risks and complications of olecranon bursa aspiration?

  • On examination, if the sample shows the presence of microorganisms, then your doctor may prescribe antibiotics.
  • If there’s no infection found, your doctor might prescribe oral anti-inflammatory medicines or elbow pads.
  • Refrain from activities that may place pressure on the swollen elbow. 
  • Apply ice packs on the inflamed area. 
  • Complications may include infection or abnormal connection between skin entry and bursa (fistula formation).

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Medically Reviewed on 7/8/2020
References
Medscape Medical Reference

ASSH.org
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