Hemorrhagic bursitis of the elbow joint treatment. Ointment for elbow bursitis. Treatment of serous bursitis

Olecranon is a condition characterized by tissue damage and inflammation of the bursa (bursa) of the olecranon (a small fluid-filled sac located at the back of the elbow), which can be a source of pain in the back of the elbow.

The elbow is formed by the union of the humerus and the ulna of the forearm. The ulna has a bony protrusion located at the back of the elbow known as the olecranon. This bony protrusion is the attachment point for several muscles, including the triceps, and forms the outermost point of the back of the elbow. Between the olecranon and the overlying skin is a bag (bursa) of the olecranon. The bursa is a small sac filled with fluid - a lubricant and its function is to reduce friction between adjacent layers of soft tissues.

The triceps muscle is mainly responsible for elbow extension and is especially active during pushing activities. During the contraction of the triceps, friction is directed to the ulnar bursa. Pressure on the olecranon bursa can also result from a direct blow. When this pressure on the bursa is excessive due to too frequent movements or the application of force, then conditions arise for inflammation of the olecranon bursa.

The reasons

• Moderate but repetitive trauma is the most common cause. For example, people who lean on their elbows cause friction and mild tissue trauma over the olecranon. For example, there are such terms as “student's elbow”, plumber's elbow or miner's elbow and these terms are based on long-term support on the elbows.
• A single injury, such as a blow, to the back of the elbow can cause inflammation.
• . One or more bursae may become inflamed as a result of polyarthritis (but in most cases, olecranon bursitis is not associated with arthritis).
• Bursa infection. This can happen if there is an incision in the skin over a pouch that the bacteria enters.
• Idiopathic. In many cases, bursitis occurs for no apparent reason. However, it is possible that in some people the bursitis is due to a minor injury that has been forgotten.

Symptoms

Normally, a person cannot feel or see the bursa. If inflammation of the bursa of the olecranon occurs, then there is a thickening of the skin and swelling on the back of the elbow. The bursa can also be filled with fluid and then looks like a small soft ball - a bit like a cyst. In most cases (uninfected and non-arthritis related bursitis), ulnar bursitis is painless or mildly painful. Movement in the elbow joint is not disturbed.

If the bursa becomes infected ("septic" olecranon bursitis), the elbow usually develops pain, redness, and tenderness.

Arthritis-related bursitis may be painless on its own, but there may be joint pain associated with arthritis. Patients with olecranon bursitis usually experience pain and swelling at the back of the elbow. The pain usually worsens when leaning on the elbow or when bending or straightening the elbow. In less severe cases, patients may only experience pain and stiffness in the elbow at rest after activities such as carrying a bag. In addition, activities such as using a hammer or straightening the elbow against resistance can also cause pain in the initial stages.

As it progresses, patients may experience symptoms that increase during sports or physical activity. Patients may notice swelling and a large protrusion above the elbow protrusion. Most patients with olecranon bursitis experience pain when touching the olecranon. Sometimes small lumps can be felt in the area of ​​the olecranon. Patients may also experience weakness in the elbow, especially when attempting to straighten the elbow against resistance.

Diagnostics

As a rule, a physical examination by a doctor is enough to make a diagnosis. But in order to exclude the possible presence of infection or arthritis, it is also necessary to conduct laboratory tests and x-rays. In some cases, to exclude the tumor genesis of the formation, it is possible to prescribe CT or MRI.

Treatment

In most cases, ulnar bursitis can be self-healed by reducing the load on the elbow. But in some cases, medical intervention up to surgical is required.

Conservative treatment for ulnar bursitis includes:

• Rest and change of activity. Patients with ulnar bursitis should avoid activities that put pressure on the elbow. Wearing elbow pads can also help protect the elbow bag from pressure or additional irritation.
• Cold. Applying a cold compress to a swollen elbow for 20 minutes two or three times a day can help relieve symptoms and reduce swelling.
• Compression. Using an elastic bandage wrapped around the affected joint can help reduce swelling.
• Elevation. Raising the elbow to or above heart level reduces blood flow and thereby reduces inflammation.

Medical treatment. Nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen (eg Advil), naproxen (eg Aleve), and COX-2 inhibitors (eg Celebrex) may reduce swelling and inflammation and relieve pain associated with elbow bursitis.

Aspiration. Aspiration of the swollen bursa with a needle and syringe allows immediate relief of pressure. Aspiration is also done to test the fluid for microbes. (A positive test would mean septic bursitis).

Corticosteroid injections. The symptoms of bursitis can be greatly reduced with corticosteroid injections. Corticosteroids are powerful anti-inflammatory drugs, and administering them directly to the inflamed bursa usually reduces pain and swelling significantly. However, corticosteroid injections have potential side effects such as infections and degeneration of the skin on the elbow. Thus, these injections are usually reserved for persistent bursitis and other treatments that have failed.

Antibiotics. Septic bursitis of the olecranon requires antibiotics. The choice of antibiotic depends on the microorganism that is causing the infection (most often Staphylococcus aureus). Most people with septic bursitis are treated with antibiotics fairly well, and in some cases hospitalization and intravenous antibiotics are required.

Surgery

Sometimes, chronic bursitis or septic bursitis may require surgery. In a traditional bursectomy, an incision is made in the elbow and the inflamed bursa is removed. Since the bag is under the skin, the elbow joint is not affected during the operation.

Complications of surgical removal of the bag can be problems with healing of the skin at the incision site and soreness. A few months after the operation, as a rule, a new bursa grows at the site of the removed bursa.

exercise therapy. After the symptoms of bursitis subside, the appointment of exercise therapy is quite effective to strengthen muscle tone.

Forecast

Most patients with this disease recover and return to their normal lives within a few weeks. Sometimes, rehabilitation can take much longer (up to several months) in cases where bursitis has been going on for a long time. Therefore, early treatment and rehabilitation is necessary to restore a normal quality of life.

- this is an inflammatory process that has arisen in the tissues surrounding the olecranon. In order to understand what is at stake, you should know that around any joint, including the elbow, there are synovial bags filled with a small amount of fluid, which in Latin are called bursa. In the normal state, they perform the same role as lubricants in the engine, that is, they do not allow rubbing against each other during movement. Therefore, they are not injured as a result of natural human activities.

If we consider specifically the elbow joint, then it is surrounded by three bursas:

Interosseous

Ulnar subcutaneous

Interosseous ulna

Each of them contains a certain amount of fluid, which normally performs its function, so a person does not experience pain when moving his hands. But sometimes, for a number of reasons, inflammation occurs in the cavity of one or several synovial bags at once, the fluid begins to arrive, its composition changes, and the elbow becomes painful. This condition is called elbow bursitis.

Doctors classify bursitis according to several parameters:

Depending on the place of localization (by the name of the synovial bags).

By the nature of the course of inflammation - acute, subacute or chronic type.

Depending on the composition of the fluid (exudate) accumulating in the synovial sac - purulent, serous, fibrous, hemorrhagic.

If bursitis is caused by any microorganism, then it may have the name of non-specific (microorganisms from the strepto-and group) or specific (for example, caused by gonococci, spirochete pallidum, tuberculosis or syphilitic bacterium).

Inflammation of this slit-like formation on the elbow is a fairly common phenomenon and is in second place after inflammation of the shoulder joint.

Causes of elbow bursitis

Bursitis of the elbow joint can occur for a number of reasons, among which it is customary to single out the following:

In the first place, as a factor leading to the development of bursitis, is arthritis of any nature - psoriatic, rheumatoid or gouty. That is, against the background of acute inflammation in the cartilage itself or in the synovial bag, fluid begins to accumulate, which leads to the formation of bursitis.

Bursitis can be the result of a microtrauma, but this is somewhat less common. The elbow is injured due to constantly repetitive monotonous movements, therefore this disease is unofficially called the "professional" illness of all those people whose activities are associated with the support of the elbow on a hard surface. These can be students, engravers, chess players, draftsmen, etc. In such people, the subcutaneous ulnar bursa most often becomes inflamed, and, for example, in tennis players, the interosseous ulna. Such a difference is associated with the peculiarities of the distribution of the load on the elbow, and hence the place of occurrence of microtraumas.

Sometimes bursitis occurs some time after a mechanical injury to the elbow. In the event that a person hits or falls on this part of the body.

Bursitis can also occur as a result of ingestion of an infection. Especially often this happens when the skin tissue immediately next to the bursa has been damaged, and a certain microorganism or bacterium has got inside. Panaritium can also serve as an infectious cause of bursitis, when bones and soft tissues of the fingers are exposed to acute inflammation. Also, the infection can get into the synovial sac not from the outside, but “from the inside”, that is, it can be carried through the blood (hematogenous pathway) and through the lymph (lymphogenic pathway).

Extremely rarely, however, there is an idiopathic inflammation of the synovial bag, that is, one whose etiological causes remain unclear.

Even among the risk factors leading to the occurrence of inflammation in the elbow joint, some chronic diseases are considered, for example,. The cause of suppuration can also be a general weakening of the immune system, metabolic disorders, as well as taking steroid drugs.

As the main symptoms of bursitis of the elbow joint, it is customary to distinguish the following:

The occurrence of swelling in the corresponding area. Sometimes it can occur for no apparent reason, be completely painless and not interfere with the free movement of the hand.

If the swelling is left unattended, then over time it will become much more noticeable, increase significantly in volume and there will be a feeling of discomfort and pain.

Often there is reddening of the skin around the elbow and its sharp filling.

Among inflammatory diseases of the musculoskeletal system, bursitis of the elbow joint is often diagnosed. Many patients find this surprising because the elbow joint does not experience as much stress as the hips, knees, and ankle joints.

But the shoulder, and especially the elbow, can be loaded significantly, and the load can be both static and dynamic. Particularly harmful are cyclic or repetitive movements that are performed regularly, which leads to aseptic inflammation of the olecranon, and its surrounding auxiliary formations - articular bags. How does bursitis present, how is it diagnosed, and what are the treatments for elbow bursitis?

Definition

Any bursitis is called inflammation of the auxiliary apparatus of the joint, namely the bursa, or articular bag. In this case, we are talking about inflammation of the intra-articular bag of the olecranon.
The human elbow joint has a complex anatomical structure. Its function is to ensure the independence of brush movements and at the same time streamline them. The overlying joint (shoulder) is the joint with the maximum degree of freedom, and movement in the shoulder is possible in three planes. The elbow joint performs movements in 2 degrees of freedom, performing flexion-extension, as well as supination and pronation (rotation of the forearm inward and outward).

At the same time, the joint bags secrete synovial fluid, which facilitates the movement of articular cartilage, reduces friction, and also protects the joint from the outside. There are three such bags in the elbow joint.
Any allergic, infectious or traumatic process can disrupt the release of synovial fluid and lead to the development of acute or chronic inflammation of one or another intraarticular bag, and sometimes several at once. Consider the main causes of the development of bursitis.

Causes of the disease

Bursitis, like any inflammation, can be aseptic, that is, arising without the participation of harmful microorganisms, and infectious. The following reasons lead to the development of aseptic bursitis:

• metabolic disorders, for example, the accumulation of crystalline substances (urates) in the joint cavity and in the tissues of the joint capsules. These are bursitis, arthritis and bursitis with terminal uremia (urea). Such diseases are called crystalline bursitis;
• prolonged static tension in the elbow joint, with support on the surface. This situation occurs in persons of certain professions, or when they are in a motionless position for a long time, for example, in a state of intoxication. In addition, there may be opposite situations associated with excessive stress on the joint, for example, in some sports. So, there is the concept of "tennis elbow". It is very harmful to work at a computer with constant support on the elbows;
• severe trauma, such as a bruise, can also lead to aseptic inflammation. Violation of tissue integrity does not occur here, but reactive aseptic inflammation with exudation occurs, as a result of which inflammation of the elbow joint develops, and then bursitis. Traumatic bursitis also often develops with chronic, minor impact, but permanent damage to the articular tissues. Such microtraumas must occur over a long period of time for symptoms to develop. The post-traumatic process is typical for athletes;
• sometimes the cause of inflammation of the articular bags is an allergic reaction. This happens infrequently, but happens if the patient has a polyvalent allergy. Also, a pronounced toxic edema of allergic origin can develop with bites, for example, of wasps or bees.

infectious process

In a significant number of cases, bursitis of the elbow joint is infectious. Most often, infection occurs with cuts, open wounds, or with hematogenous and lymphogenous infection from distant foci.

Usually the second way of infection is typical for patients with a significant decrease in immunity, for example, undergoing chemotherapy, or suffering from HIV infection.

Infectious bursitis can be either specific or nonspecific. In the first case, we are talking about special pathogens, which are characterized by a bright, unique clinical picture. Such diseases include tuberculosis, syphilitic or brucellosis bursitis. Recently, arthritis and bursitis caused by the causative agent of gonorrhea have often been recorded.

In a non-specific infectious process, various pathogenic cocci, for example, hemolytic streptococcus or Staphylococcus aureus, are most often the cause of infection.

It is not uncommon for cases in which infectious lesions of the articular bags can be caused by a viral infection, for example, serous bursitis of the elbow joint in children can be a symptom of adenovirus infection or influenza, although in rare cases.

In the event that the inflammatory process occurs in any other organs, and bursitis occurs as a reaction to the general process, then they speak of reactive bursitis.

Classification

It is possible to classify ulnar bursitis by localization, by the nature of the exudate and by the nature of the inflammatory process. So, according to localization, three different bags are distinguished - the bag of olecranon, or the olecranon, intratendinous and supratendinal. The closer to the surface of the skin is the bag, the greater the risk of damage. Therefore, the bag of the olecranon most often suffers from bursitis in this joint.

According to the composition of the exudate, bursitis can be:

• serous;
• hemorrhagic;
• purulent;
• fibrinous.

Serous bursitis is called if a transparent serous fluid has accumulated in the bag, which is little different from synovial fluid. Hemorrhagic bursitis of the elbow joint often occurs after an injury, and may be a manifestation of internal bleeding into the cavity of the bag, when blood is pumped out of the bag during a puncture. With infectious lesions, purulent bursitis most often occurs, which can be dangerous by melting the surrounding tissues, and with chronic lesions, fibrinous bursitis sometimes occurs. In this case, an adhesive process associated with the chronic course of the disease often develops.

Sometimes there may be a deposition of lime in the bag of the joint. Such deposition of lime salts rarely occurs as a primary process, and more often develops in old age against the background of significant metabolic disorders, such as renal failure and diabetes mellitus. In this case, we are talking about the accumulation of calcium salts in the walls and cavity of the bag. This leads to impaired secretion of synovial fluid, loss of tissue elasticity, and can occur not only as a primary lesion, but also as an outcome of chronic and long-term bursitis of any etiology.

The disease can be both acute, subacute and chronic. Acute bursitis is most often infectious and purulent, and chronic inflammation is characteristic of a systemic lesion of the connective tissue, for example, with gouty bursitis, or against the background of rheumatic pathology.
Also, a chronic course is characteristic of aseptic lesions against the background of an increased load on the elbow joint, for example, in case of an occupational disease. What does bursitis look like, and what is the clinical picture of a typical acute lesion?

Clinic and symptoms of an acute process

Consider how a typical acute bursitis of the elbow joint proceeds. Take for example an acute purulent inflammation, in which it is imperative to consult a doctor, since delay can lead to the need for a serious operation, and in some cases even amputation of the forearm.

The most characteristic signs of purulent inflammation of the ulnar bursa are:

• a few days after receiving a contaminated wound, scratch, or the onset of an acute infectious process, such as pneumonia, redness appears in the elbow area. Redness is the first symptom of inflammation;
• swelling occurs, when you try to press on the elbow, a seal is felt, resembling a pillow pumped up with water, or an elastic bump. This indicates the appearance of an effusion in the cavity of the bag;
• acute ulnar bursitis is manifested by a feeling of local heat: the affected elbow is much hotter to the touch than the joint on the healthy side;
• soreness. The affected elbow begins to "twitch", pain occurs, which intensifies with movement.

There may also be associated symptoms - fever, chills and fever, malaise.

In the event that only the bag is affected, there may not be any particular pain, but when the process spreads to the joint and surrounding soft tissues, signs of bursitis are replaced by symptoms of arthritis and even panarthritis. Then the purulent inflammation becomes extensive, and the pain becomes very strong. The consequences of bursitis of the elbow joint in the event of a secondary infection can be sad - total arthritis will occur, which can gradually transform into ankylosis with the development of disability and immobility of the joint.

To avoid pain at the slightest concussion of the joint, the patient is forced to wear his elbow with a healthy hand, or tie it to a scarf. As a result, there is a dysfunction of the joint, which ultimately affects a significant limitation of its mobility.

Signs of chronic bursitis are more subtle, with alternating exacerbations and remissions, and often do not have pronounced symptoms, except for a feeling of fatigue and swelling in the elbow.

Diagnostics

The primary diagnosis of elbow bursitis can be made by any doctor, since the signs are characteristic and indicate damage to a particular joint. Which doctor to go to for treatment depends on the process: for example, with gouty bursitis, you need to go to a rheumatologist, and with a purulent process, to a surgeon. First you need to contact the local therapist, he will refer the patient to the right specialist.

The following methods are widely used in the diagnosis of this disease:

• radiography of the joint;
• if you suspect a lesion of deep ligaments -;
• puncture of the elbow joint with bursitis allows you to determine the nature of the exudate, and often, after bacterial seeding, isolate the pathogen that caused the inflammation.

General clinical tests, such as a complete blood count, can show inflammatory changes with a pronounced process,

Treatment

How can bursitis of the elbow be cured, and what methods are there for this?
The defeat of the bag of the olecranon involves conservative or surgical treatment.
The operation is performed most often in a chronic process or with a pronounced accumulation of pus. First, a puncture of the synovial bag is done, not only for diagnostic, but also for therapeutic purposes. b

Pus is pumped out, the bag is washed with antibiotics, and anti-inflammatory drugs, including corticosteroid hormones, are administered. Sometimes the puncture is performed several times.

In the event that there is a pronounced purulent process, after opening the bag, drains are left in its cavity. And only if the above methods are ineffective, a complete excision is performed and then the bag is removed. This operation is called a bursectomy, or "removal of the bursa."
But most often conservative treatment is carried out using pills, injections and treatment with folk remedies.

Non-steroidal anti-inflammatory drugs

Treatment of any disease of the musculoskeletal system at home, first of all, involves taking medications that belong to the group.

They are used in different dosage forms, for example, Ibuprofen, Nise (Nimesil) - in tablets, and Movalis - in the form of intramuscular injections.

How long is acute pain syndrome treated? Usually, these drugs are not given long-term, as many of them can adversely affect the liver and stomach lining. Drug treatment must necessarily be supported by the appointment of omeprazole in patients with a history of peptic ulcer. The average duration of taking NSAIDs should not exceed 10 days, with injections at the beginning, and then the patient is transferred to tablets.

Hormones

In some cases, the appointment of corticosteroid drugs, such as Kenalog or Diprospan, is indicated. They are injected directly into the bag and have a long-term anti-inflammatory effect. This therapy is indicated for aseptic variants of inflammation, for example, for chronic occupational bursitis. Long-term therapy can lead to a weakening of connective tissue formations, so do not administer hormones for a long time and often.

Antibiotics

With purulent bursitis, the patient must be given broad-spectrum antibiotics. They are used in the form of intramuscular or intravenous injections. If it is possible to determine the sensitivity of pathogenic microflora to antibiotics, a specific drug is prescribed.

With non-purulent inflammation of the articular bag, antibacterial agents are used orally, in tablets, to prevent infection.

Local therapy

In the treatment of this disease, topical preparations are also used, which can cause activation of tissue metabolism, reduce edema, and also enhance the body's immune response. Treatment with Dimexide refers specifically to the method of exposure that activates and excites the tissue response. Dimexide for bursitis of the elbow joint is used in the following way: a napkin moistened with a solution of Dimexide diluted with water 1: 3 is applied to the area of ​​the elbow joint, and this compress lasts for about half an hour. The course of treatment is 10 days. Before starting treatment, you need to check if there is an allergy. For this, a 50% solution of Dimexide is exposed for 15 minutes on the inner surface of the elbow bend.

With bursitis, various creams and ointments are used that contain NSAIDs. These are Fastum - gel, Dolgit - cream, products with bee and snake venom. Apizartron and Nayatoks, or Viprosal are effective. Ointments for bursitis are applied at night, as they are slowly absorbed and have a fatty base. And creams and gels are good for daily use.

In the event that the patient has purulent bursitis, an operation was performed and drains were installed, then Levomekol, or Vishnevsky ointment, is indicated for the treatment of purulent wounds, which have a strong disinfecting effect and stimulate the formation of granulation tissue.

When can thermal treatments be used?

If the patient has chronic inflammation of the ulnar bursa caused by increased load, then folk remedies are often used, since the course of the disease is long, and the degree of dysfunction may be insignificant. In this case, thermal procedures can be applied. Patients often ask if it is possible to go to the bath with bursitis?

It is possible, but not in the phase of acute inflammation, but when you feel better. The thermal procedure will promote blood flow and increase venous outflow. In the event that the patient has a clinic of acute bursitis, then procedures such as a bath or massage of the elbow joint can lead to increased swelling and increased pain. In the same case, if the patient has chronic bursitis of the elbow joint, during an exacerbation, the use of these methods will lead to the development of a relapse of the disease.
In this situation, you need to cool the affected area. For this, peppermint essential oil, diluted in base oil in a ratio of 1:10, is suitable; cooling gels, such as Ben-Gay or Bom-Bengue, based on methyl salicylate and menthol; or, finally, you can simply tie a cabbage leaf to your elbow. All this will cause relief and reduction of pain.

Recovery and rehabilitation

Rehabilitation in order to restore mobility in the joint should begin from the first days after the removal of pain. The rest time for the joint should be minimal, since immobility leads to wasting of the surrounding muscles and changes in the tendons. On the first day after the onset of severe pain, it is imperative to hang the limb to the neck, for this there are special bandages, or an elastic bandage can be used. In the event that the patient has signs of chronic bursitis and the history of the disease is long enough, it is necessary to use a brace for the elbow joint, or an elbow orthosis, during exacerbations.

The tasks of exercise therapy for elbow bursitis are to restore the mobility of the joint, improve the production of synovial fluid, reduce the production of exudate in the cavity of the bag, improve the blood supply to the joint capsule, and improve the outflow of venous fluid containing harmful substances. Physiotherapy exercises should be performed already at the stage of subsiding exacerbation, always under the guidance of an experienced instructor. So, you need to avoid exercises with a small amplitude of movements, and weights are prohibited.

Prevention

The basic principles for the prevention of elbow bursitis are to avoid situations of chronic and accidental injury. Athletes need to wear protective bandages, motorcyclists need to wear elbow pads.

In the event that a microtrauma, wound or abrasion occurs, they must immediately be treated with antiseptics, for example, hydrogen peroxide, and a bandage applied. Pustular diseases should be treated in a timely manner, and if there are signs of acute arthritis, you should contact a rheumatologist without waiting for exacerbations.

In old age, great importance should be given to hygiene of movement, since there is an age-related decrease in the production of synovial fluid, as well as a decrease in blood supply and nutrition of muscle tissue. You can not experience serious stress, and especially in conditions of hypothermia. Finally, when working at a computer, you need to reasonably alternate periods of work and periods of rest, during which you need to do a set of gymnastic exercises.

With inflammation of the synovial bag in any person, the general condition worsens.

This is the first sign of bursitis. It can be found in the area of ​​any joint: hip, shoulder, knee.

However, more often in patients of different ages, serous or traumatic bursitis of the elbow joint is diagnosed: the symptoms, causes and effective treatment at home and in the hospital will be discussed further in the article.

The disease is quite serious, so it is better to stop the inflammatory process at the initial stage. The consequences and complications are quite unpredictable.

You need to know how the treatment of bursitis of the elbow joint is carried out correctly, which specialist you can contact, what to do if the arm in the fold is unbearably sore.

Elbow injury is a fairly common occurrence. It happens in adults and children. Some do not pay attention until pain occurs, others experience a traumatic shock and cannot recover for a long time.

Minor damage, inadvertent movements, sharp blows can lead to injury. As a result, bursitis of the elbow joint develops, the article offers the main symptoms and methods of treatment for acquaintance.

Bursitis of the right and left elbows appears for various reasons. Inflammation of the joint capsule, nerves, tendons and muscles located in the neighborhood occurs from a blow, bruises, microtraumas, abrasions.

Other equally common causes of post-traumatic elbow bursitis:

1. finding the arm for a long period of time in a very uncomfortable position, when the elbow is tense, pinched or lowered from the working surface;
2. salt deposits near the joints;
3. the presence of arthritis, diabetes;
4. unsuccessful limb movement;
5. drug treatment with steroids.

The risk group includes people who receive increased stress on the elbow area: athletes, draftsmen, office professionals.

The mechanism of the development of the disease

The disease, called bursitis of the elbow joint, has its own characteristics of occurrence and course.

There is inflammation of the articular or ulnar bursa, which is a small capsule filled with synovial fluid.

She is assigned the role of a shock absorber that protects the periarticular tissues and bones from friction.

As soon as the infection gets into the bursa, the process of inflammation begins. The amount of synovial fluid immediately increases, its composition gradually changes.

It is noticeable that the elbow is swollen. Pain is felt, the joint becomes inflamed. The bag continues to expand, swell.

Edema becomes noticeable. Very soon, in addition to the synovial fluid, purulent mucus or blood clots will appear in the inflamed bag.

With such symptoms, the presence of bursitis of the hemorrhagic elbow joint is usually stated.

Infection accompanies the purulent process. It is localized not only in the region of the left or right elbow, but also passes to neighboring tissues. Purulent bursitis of the elbow joint is unpredictable, dangerous.

The consequences may be different:

• calcification;
• tissue necrosis;
• formation of adhesions.

Unlike other diseases, chronic bursitis of the elbow joint has distinctive features:

1. There is no fat layer on the elbows, so the muscles are not protected. About the same knees hurt when the synovial bag becomes inflamed.
2. It affects three synovial bags at once, but the bursa located in the region of the olecranon on the extensor surface suffers more.

Otherwise, ulnar bursitis has symptoms similar to other diseases.

Symptoms of elbow bursitis

Having found out why bursitis of the elbow joint occurs, it is necessary to identify its symptoms, by which the disease is determined. Symptoms directly depend on the type of disease.

Serous bursitis is acute and chronic. It differs in that the fluid in the synovial sac resembles serum, but the exudate is not infected.

Its symptoms are pronounced, but pay little attention to themselves:

• the elbow is slightly swollen, it hurts when making any movements;
• swelling appears in the area of ​​pain localization;
• the temperature rises slightly (up to 37.5º), but a surge of heat is felt at the site of the joint lesion;
• around the bursa, the skin turns red.

X-ray shows that there are no internal injuries of the joints, but the cavity of the synovial bag is significantly enlarged (up to 10 cm), which means that there will be a violation of motor function.

Left untreated, elbow bursitis will progress from acute serous to chronic, and symptoms will become less noticeable.

Let's stop what acute purulent infected elbow bursitis looks like. His symptoms are different. The key point is the pain felt even with a light touch.

Other symptoms:

1. the presence of significant edema due to the accumulation of synovial fluid;
2. the swelling sharply increases in size (up to a chicken egg);
3. sprawling puffiness to neighboring tissues;
4. redness of the skin in the elbow area;
5. there is a restriction of movements;
6. the temperature rises to 39º;
7. on palpation, a pulsation is felt at the site of the lesion.

Pus can be seen on the skin if there are wounds from injuries.

If the elbow is swollen, inflammation of the elbow joint with bursitis continues, treatment should begin immediately.

Otherwise, new symptoms will appear: open fistulas, phlegmon, worsening of the general condition. Only a surgeon can completely cure such a pathology.

A puncture, surgery and long-term rehabilitation after a course of therapy are ahead.

Acute hemorrhagic bursitis is characterized by the presence of blood cells in the fluid. The cavity of the bag increases, becomes inflamed. There is swelling of the tissues.

To stop the spread, you have to make a tight bandage to fix the joint. Sometimes surgical removal of the bag is required.

Types of pathologies

The disease of post-traumatic and traumatic bursitis of the elbow joints is different in course, causes.

Modern medicine gives classification in several directions. The division is carried out according to the intensity of pain, the consequences and complications are taken into account.

Three forms of pathology are determined by the nature of the course:

• Acute. The main symptom of olecranon bursitis is pain. The temperature often rises. Against its background, intoxication is observed. Limitation of limb movements is detected. Any slight load causes discomfort.
• Chronic. Pain sensations are practically absent, however, signs of physical weakness appear periodically. The elbow area hurts, the swelling is insignificant. When you feel the focus of the disease with your fingers, you feel a seal in the area of ​​the bursa.
• Recurrent. If post-traumatic bursitis caused an elbow bruise, after the completion of treatment, infection may occur due to a violation of the integrity of the skin. Pathogenic microorganisms enter the exudate, a new round of the disease begins.

The composition of the synovial fluid must be considered when deciding how to treat elbow bursitis after diagnosis.

In this case, the classification looks like this:

1. Serous: a fluid is formed in the synovial sac, resembling serum in consistency. This type is distinguished by mild pain in the joint. You feel unwell, a slight swelling is found. Its color is light. The disease resolves fairly quickly with limited physical activity. Surgical treatment is not required. Medicine offers a number of effective methods of treatment, including the provision of assistance with folk remedies.
2. Purulent: pus is detected in the composition of the fluid in different amounts. Infected bursitis is caused by pathogenic microorganisms. The patient becomes lethargic, sometimes irritable due to constantly felt pain. It is possible to cure completely, but you will have to undergo a therapeutic course. Sometimes the infected bursa needs to be removed. The disease is dangerous, but effectively treated. It is necessary to undergo a course of therapy immediately to cope with the symptoms that have arisen.
3. Hemorrhagic: the main symptom of the disease is the presence of blood in the fluid. The exudate looks rather unusual: a pink hue is noticeable due to the presence of erythrocytes in it. Trauma may be the cause.

Often, medicine notes that bursitis is mixed. In the presence of a fibrous lunge, it is called serous-fibrous. The disease can develop according to a purulent-hemorrhagic type.

Often the cause of the disease, when the elbow swells up, becomes an infection.

The division is carried out in two ways:

• Nonspecific: caused by staphylococci, streptococci, and other pathogens.
• Specific: the cause of inflammation of the synovial sac is gonococcus, pale spirochete.

Diagnosis of bursitis

After conducting a visual examination of the left and right elbow, comparing them, after listening to the patient's complaints, he determines ulnar bursitis, but medication or surgery will be prescribed after additional studies.

To clarify the diagnosis and identify the type of disease, it is proposed to do:

1. X-ray: recommended to identify the condition of the bone process, on which osteophytes can form. Based on the results of the X-ray examination, the doctor decides whether an operation or medication will be performed.
2. Puncture: synovial fluid is removed from the joint bag through a puncture to study its composition. Puncture for bursitis is performed with a 18-20 G needle with the joint extended. The study of exudate is carried out in the laboratory.

Clinical studies are being conducted to determine how long the inflammation lasts, what character it has.

Analyzes are given:

• blood from a finger for leukocytosis and an increase in ESR;
• blood from a vein for a serological test to detect an antigen.

If the specified medical examination is not enough, ultrasound, MRI and CT are prescribed.

Treatment of bursitis of the elbow joint

Only a doctor who has received the results of all prescribed studies, who has examined the patient, decides how much and how to treat elbow bursitis.

Restriction of physical activity is prescribed immediately if the elbow is swollen. Physical education is not practiced, but fixing bandages will be effective.

With severe pain, you can apply compresses with painkillers, lubricate the elbow with gels. The appearance of infection and complications can be avoided if antibiotics are immediately prescribed to the patient.

The course lasts until recovery occurs. Having identified purulent or hemorrhagic bursitis of the elbow joint, the surgeon decides how to effectively treat. You will need to remove the exudate from the elbow bag.

An x-ray is prescribed first, then a puncture. The doctor decides where to make a puncture. Under sterile conditions, a needle is inserted into the bag to extract the liquid. An unpleasant pain is felt, but it passes after the completion of the manipulation.

1. is introduced into the Kenalog bag;
2. ointments Ibuprofen, Voltaren are locally prescribed;
3. physiotherapy is recommended.

The operation is prescribed for elbow bursitis, when conservative treatment is unpromising. Usually, such a radical method is resorted to when a puncture, drug recovery is ineffective, the disease becomes recurrent.

The operation helps to stop the disease, prevent the spread of pus to neighboring tissues, and go beyond the process.

Surgery is of two types:

• excision of a part of the affected bursa;
• complete removal of the synovial sac by the doctor.

Which surgery is better to choose, the doctor will decide. Be sure after the procedure, a long rehabilitation is required. Physiotherapy may be prescribed.

Conclusion

This article is only a story about the disease of the joints. It does not replace a trip to the doctor and does not take on a healing function.

Restore her information in memory and be sure to visit a specialist. Remember, bursitis doesn't go away on its own.

It is dangerous, so only a specialist can completely cure it: a surgeon, a rheumatologist, a chiropractor, an orthopedist.

How long the recovery will last depends on the behavior of the patient, correctly chosen methods. Rehabilitation will speed up the process of returning to working capacity.

Video: Treatment of bursitis of the olecranon