To help skin run over a bony prominence, such as the elbow, there is a lubricating fluid filled sac, called a bursa. The bone that makes up the point of the elbow is the olecranon. An olecranon bursa can become inflamed (bursitis). The most common causes of olecranon bursal swellings are trauma, infection and gout. Other conditions can cause swellings in a similar area such as rheumatoid nodules. Most traumatic bursal swellings are temporary, spontaneously resolving over 2-3 months.
Infected bursae may require acute hospital admission for intravenous antibiotics and surgical drainage. Several courses of antibiotic therapy may be required to settle the infection.
If the bursa becomes chronically swollen and is troubling then surgical excision can be considered. This requires an anaesthetic. The surgery can be performed in less than an hour. Some patients have a bony spur on the olecranon that will also be removed. Patients usually stay overnight and are discharged after drain removal the following morning. The wound will take 2 weeks to heal. The main risks are fluid accumulation in the excised space (resorbs over 6 weeks), wound problems and infection. The bursa usually reforms but recurrent swelling is rare.