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[Conditions](https://durgical.com/en/conditions/) · [Upper limb](https://durgical.com/en/anatomy/region/upper-limb/)

# Olecranon bursitis

Olecranon bursitis is a swollen, fluid-filled sac at the point of the elbow, caused by pressure, injury, gout or infection.

Updated 2026-10-29

## Structures involved

Tap one to see what it is and open it in 3D.

- [Olecranon bursa](https://durgical.com/en/anatomy/olecranon-bursa/)
- [Ulna](https://durgical.com/en/anatomy/ulna/)
- [Triceps bursa](https://durgical.com/en/anatomy/subtendinous-bursa-of-triceps/)
- [Triceps (long head)](https://durgical.com/en/anatomy/triceps-brachii-long-head/)
- [Triceps (medial head)](https://durgical.com/en/anatomy/triceps-brachii-medial-head/)
- [Elbow capsule](https://durgical.com/en/anatomy/elbow-joint-capsule/)

## Why it happens

- [Patterns of acute inflammation: serous, fibrinous, purulent, abscess, ulcer](https://durgical.com/en/general-pathology/patterns-of-acute-inflammation-serous-fibrinous-purulent-abscess-ulcer/)
- [Synovial joints: capsule, synovial membrane and articular cartilage](https://durgical.com/en/histology/synovial-joints-capsule-synovial-membrane-and-articular-cartilage/)

## What it is

Inflammation of the superficial bursa over the tip of the elbow, which fills with fluid and forms a soft swelling. It can be aseptic (pressure, injury, gout or rheumatoid arthritis) or septic (bacterial infection), and telling them apart guides treatment.

## Who gets it

Common in adults, more often men, and in jobs or habits that lean on the elbow (manual workers, miners, students, drivers). Septic cases are a substantial share of those seen in emergency care.

## Causes

- Repetitive pressure or friction on the elbow (leaning on desks, kneeling-type work done on the elbows)
- A single blow or fall on the point of the elbow
- Crystal disease (gout, calcium pyrophosphate deposition) or rheumatoid arthritis
- Infection, most often by Staphylococcus aureus and then streptococci, through a skin break or nearby cellulitis

## Risk factors

- Occupations or sports with pressure on the elbow
- Gout, rheumatoid arthritis or chronic [kidney](https://durgical.com/en/anatomy/kidney/) disease on dialysis
- Diabetes, alcohol use disorder, immunosuppression or corticosteroid therapy (for septic bursitis)
- Skin abrasions, wounds or eczema over the elbow

## Pathophysiology

The [olecranon bursa](https://durgical.com/en/anatomy/olecranon-bursa/) lies just under thin skin, so pressure or trauma readily irritates its lining, which then produces excess fluid. In septic bursitis bacteria enter through the skin and cause a purulent collection with surrounding cellulitis. Because the bursa does not communicate with the elbow joint, joint motion is usually preserved.

## Classification

- Aseptic (traumatic, idiopathic, crystal-related or rheumatoid)
- Septic (bacterial)
- Acute or chronic

## Symptoms and signs

- Soft, fluctuant swelling over the point of the elbow, sometimes large
- Little pain in aseptic cases; marked pain, warmth and redness in septic cases
- Elbow motion largely preserved, with discomfort mainly at full flexion
- Fever, spreading redness or a skin wound suggesting infection

## Red flags

- Fever, spreading cellulitis or red streaks up the arm
- Painful, restricted elbow motion, which points to septic arthritis of the joint instead
- Immunosuppressed patient or signs of systemic infection
- Pus draining from a sinus over the bursa

## Diagnosis

**Clinical**
Swelling confined to the bursa with preserved elbow motion. Warmth, redness, tenderness, fever and a [skin](https://durgical.com/en/anatomy/skin/) breach favour infection, but clinical signs alone do not reliably separate septic from aseptic bursitis.

**Tests**
Aspiration of the bursa when infection is suspected: cell count, Gram stain, culture and crystal analysis. Blood count and inflammatory markers support the assessment.

**Imaging**
X-rays look for an olecranon spur, fracture or foreign body; ultrasound shows the fluid collection and guides aspiration.

## Differential diagnosis

- Septic arthritis of the elbow
- Cellulitis without bursal involvement
- Gouty tophus or rheumatoid nodule
- Olecranon fracture
- [Triceps tendon](https://durgical.com/en/anatomy/triceps-tendon/) injury

## Goal of treatment

Relieve swelling and pain, eradicate infection when present, and prevent recurrence and chronic bursitis.

## Treatment

**Conservative**
Aseptic bursitis: relative rest, padding and avoiding pressure on the elbow, a compression bandage and cold; many resolve over weeks.

**Medical**
Aseptic bursitis: nonsteroidal anti-inflammatory drugs for pain; treatment of underlying gout or rheumatoid arthritis. Corticosteroid injection is debated because of infection and skin-atrophy risk.

**Medical**
Septic bursitis: antibiotics active against staphylococci and streptococci, oral for mild cases and intravenous for severe or immunosuppressed patients, adjusted to culture and local resistance patterns.

**Procedure**
Aspiration of the bursa for diagnosis and relief, repeated in septic cases if fluid reaccumulates.

**Surgical**
Incision and drainage or bursectomy for septic bursitis that does not respond, or for chronic, recurrent, disabling bursitis.

## Complications

- Chronic or recurrent bursitis
- Spread of infection: cellulitis, septic arthritis or osteomyelitis of the olecranon
- Draining sinus after aspiration or drainage
- Wound-healing problems after bursectomy

## Prognosis

Aseptic bursitis usually settles with protection from pressure, though it can recur. Septic bursitis generally responds to antibiotics and drainage when treated early; delayed treatment or immunosuppression increases the risk of surgery and complications.

## Prevention

- Elbow pads and avoiding leaning on the elbows
- Prompt care of skin wounds over the elbow
- Control of gout and rheumatoid arthritis

## Test yourself

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

## Which organism most often causes septic olecranon bursitis?

Staphylococcus aureus, followed by streptococci.

## How is septic olecranon bursitis distinguished from aseptic bursitis?

Aspiration of bursal fluid for Gram stain, culture, cell count and crystals; warmth, redness and fever raise suspicion but are not reliable alone.

## Why is elbow motion usually preserved in olecranon bursitis?

The olecranon bursa is superficial and does not communicate with the elbow joint, so the joint itself is not inflamed.

## What finding suggests septic arthritis of the elbow rather than olecranon bursitis?

Painful, markedly restricted active and passive elbow motion with a joint effusion.

## Which systemic diseases are linked to aseptic olecranon bursitis?

Gout, calcium pyrophosphate deposition disease and rheumatoid arthritis.

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## Related conditions

- [Prepatellar Bursitis](https://durgical.com/en/conditions/prepatellar-bursitis/)
- [Gout](https://durgical.com/en/conditions/gout/)
- [Rheumatoid arthritis](https://durgical.com/en/conditions/rheumatoid-arthritis/)
- [Elbow dislocation](https://durgical.com/en/conditions/elbow-dislocation/)

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

Sources: [Olecranon Bursitis](https://www.ncbi.nlm.nih.gov/books/NBK470291/) (StatPearls (NCBI Bookshelf), 2025).

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Representative model, for educational purposes only.

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