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# Olecranon bursa

The olecranon bursa is a fluid sac under the skin at the point of the elbow; it lets the skin slide and can swell after pressure or infection.

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## What it is

A thin sac between the skin and the point of the elbow.

## What it does

Lets the skin slide over the elbow tip.

## Key points

- Septic or aseptic: redness, heat, marked tenderness, a skin break, fever and spreading cellulitis favour infection; aspiration (cell count, Gram stain, culture, crystals) settles it
- Unlike septic arthritis of the elbow, elbow motion is largely kept, because the joint is not involved
- Staphylococcus aureus is the usual organism in septic olecranon bursitis

## Key facts

**Where**
Under the skin over the olecranon

**Function**
Friction pad; swells after leaning or a knock (olecranon bursitis)

## Relations

**Superficial**
[Skin](https://durgical.com/en/anatomy/skin/) over the point of the elbow

**Deep**
Olecranon and the [triceps tendon](https://durgical.com/en/anatomy/triceps-tendon/) insertion; the [triceps bursa](https://durgical.com/en/anatomy/subtendinous-bursa-of-triceps/) lies deeper, under the tendon

**Medial**
[Ulnar nerve](https://durgical.com/en/anatomy/ulnar-nerve/) in the cubital tunnel behind the medial epicondyle, close by during aspiration or excision

## How to find it

It lies over the tip of the olecranon and is not felt when normal. Swollen, it forms a soft, fluctuant, egg-shaped lump over the point of the elbow, best seen with the elbow straight.

## On imaging

Usually a clinical diagnosis. X-ray may show an olecranon spur or a foreign body; ultrasound confirms fluid, wall thickening and septa, and guides aspiration.

## Common problems

- Olecranon bursitis: a soft swelling at the elbow tip from leaning, a knock, gout or infection.
- A red, hot, painful bursa can be infected.

## How it is diagnosed

Exam; fluid may be drawn with a needle and tested for infection or crystals.

## Treatment

- Padding, avoiding pressure and a compression wrap.
- Antibiotics, and drainage if infected.
- Surgical removal of the bursa if it keeps coming back.

## Clinical notes

- Aseptic causes: repeated leaning (student's or miner's elbow), a direct blow, gout with tophi, rheumatoid arthritis
- Aspiration through an oblique path from the side, not straight down onto the tip, lowers the risk of a chronic draining sinus
- Chronic or recurrent bursitis may be excised; wound healing over the bony tip is a common problem

## Related conditions

- [Dermatitis herpetiformis](https://durgical.com/en/conditions/dermatitis-herpetiformis/)
- [Olecranon bursitis](https://durgical.com/en/conditions/olecranon-bursitis/)

## Test yourself

Think of the answer, then tap the question to see it.

## Which organism usually causes septic olecranon bursitis?

Staphylococcus aureus.

## How does olecranon bursitis differ from septic arthritis of the elbow?

Elbow motion is largely kept in olecranon bursitis, because the joint is not involved.

## Why is the olecranon bursa aspirated from the side rather than straight onto the tip?

An oblique path lowers the risk of a chronic draining sinus.

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Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
bursa subcutanea olecrani TA2 2564

**Official Spanish (DeCS)**
Bolsa subcutánea del olécranon

**English (TA2)**
Olecranon bursa

## Related

- [Triceps tendon](https://durgical.com/en/anatomy/triceps-tendon/)
- [Ulna](https://durgical.com/en/anatomy/ulna/)

Sources: Terminologia Anatomica (TA2); [Anatomy, Shoulder and Upper Limb, Elbow Joint](https://www.ncbi.nlm.nih.gov/books/NBK532948/).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/anatomy/olecranon-bursa/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/olecranon-bursa/