Olecranon Bursitis | Shoulder Elbow Hand

I woke up this morning and for some reason there seems to be a swelling the size of a golf-ball on the tip of my elbow. What on earth is it?

That sounds like an Olecranon Bursitis. The Olecranon is the medical name for the point of the elbow and a bursa is a little envelope of lubricating fluid that sits between skin and bone in various arts of the body which is prone to being rubbed. The classic one is Housemaids Knee.

This is not a little envelope.

No – not anymore. Something has irritated the bursa so instead of producing a dribble of fluid daily it has gone into overdrive and produced an eggs worth.

What do I do with it? My GP wants to drain it.

They nearly always disappear by themselves but that can take several months and I appreciate that they are pretty unsightly and can be uncomfortable when you lean on that elbow.

DO NOT LET ANYONE STICK A NEELE IN IT. This is a benign condition but there is scope for turning it into a catastrophe if it gets infected. And I mean a real catastrophe.

Can you not remove it for me?

If you are fed up with it then, yes, I can do that. It means a day in hospital; a quick general anaesthetic; an incision over the lump which I then shell out. You will need to be in a very tight bandage and resting in a sling for about 4 days afterwards to minimise the chance of it filling up again.

How can it fill up again if you’ve cut it out?

Sorry – the bursa can’t fill up again you’re right. But there is now a big space under the skin where it was and that can fill up with blood. Hence the ‘pressure bandage’.

I left mine alone and it did go down but it feels like there are bits of bone under the skin now.

That’s not bone though I know they do feel very solid. You know if you blow up a balloon and then let it deflate there is more balloon material than when you started because it has stretched? That’s exactly what happens when the bursa deflates and what you are feeling are actually ridges or folds in the lining after it has collapsed.

I wasn’t too worried about my bursa but now it has become very red and swollen and painful.

Sounds like it may have become infected. That is always a risk with a swollen bursa.

So now will you take it out?

That sounds like it is the right thing to do but in fact its not. What we do is treat the infection and let the bursa settle down and then think about taking it out. So we will give you antibiotics and keep an eye on it until it settles.

An olecranon bursa can be a pain in the elbow but it isn’t anything serious and can be excised if you are fed up with it.

The other condition that presents with a lump on the elbow is Gout but I can usually tell which is which when I examine you and the treatment is to cut out the gouty lump.

What is olecranon bursitis?
It is inflammation of the bursa, a small fluid-filled sac that cushions the tip of the elbow.

What causes it?
Common causes include prolonged pressure on the elbow, minor trauma, repetitive leaning, infection, or inflammatory conditions such as gout or rheumatoid arthritis.

Is it serious?
Most cases are mild and settle with conservative treatment, but infected bursitis needs urgent medical attention.

Can it go away on its own?
Yes, many cases resolve with rest, avoiding pressure on the elbow, and simple measures.

How can I tell if it’s infected?
Signs include increasing redness, warmth, significant pain, fever, or the skin becoming tight and shiny.

Do I need antibiotics?
Only if the bursitis is infected. Non-infected bursitis does not require antibiotics.

Can it come back?
Yes, especially if repeated pressure on the elbow continues.

Should I have it drained?
Aspiration may be considered if swelling is severe or persistent, but it carries a small risk of infection.