Thursday, January 31, 2008

Elbow (Olecranon) Bursitis

Odd topic for a plastic surgeon. Maybe. Maybe not when it's the plastic surgeon who has the problem (olecranon bursitis). That's right, earlier this week, (truly out of the blue) I set my left elbow down on the desk while writing a note. I noticed it was kind of sore/tender. Ignored it, but as the day went on it became more so. I went to the full length mirror in one of the exam rooms so I could really look at it. Red, swollen, no breaks in the skin. I didn't recall any trauma to my elbow. None of that "I hit my funny bone" stuff that makes you take notice. I still ignored it for another day as I had no elevated temp. It got worse. I called up one of the hand surgeons I had done my fellowship with back in 1989-1990. He is an orthopedic trained hand surgeon. He worked me into his busy schedule. The x-rays of my elbow were pristine. No joint abnormalities, no bone spurs, no hairline fractures, nada. That's good, but then what set off my elbow bursa? He wasn't any more sure than I was. He put me on antibiotics (red, warm to touch) and had his therapists make me a splint. He wanted to put me on an anti-inflammatory, but Aleve (helps my joints, etc) gives me severe esophagitis. Severe--burns from the posterior tongue all the way to the stomach.

Damn, I hate this splint. It's amazing the elbow motions you take for granted and the shoulder can only move in so many ways.
  • I hold the phone with my left hand, so my right is free for taking notes. Can't do that with the splint on.
  • Can't scratch my nose or much of any area above the waist, front or back, with my left hand with the splint on.
  • Tough to reach into the washer to pull out clothes with the left arm. Hadn't realized that I used my left arm for that more than the right (interesting).
  • Can't scrub in for a case with the splint on.
  • Not sure it would inspire confidence in me if patients saw me using it

Okay, I love the splint for these reasons:
  • Keeps me from knocking my elbow on the washing machine, the car door, the table top, etc
  • Able to wash dishes with the splint on (started to put this in the neutral or hate column, but recalled my Thanksgiving post and couldn't do it)
Neutral about the splint for these reasons:
  • Able to use the keyboard while wearing the splint.
  • Able to walk my dog in the splint fairly normally.
  • Did manage to do some quilting (both hand and machine) with the splint on.
  • Did manage to drive my car (safely) with the splint on.

Interesting insights, but Thank God it's not my right!!! I will honestly admit I don't wear the splint full time, but do think I have done better than 50%. My elbow is improving quickly (not as fast as the bursitis appeared but). Also, the elbow joint will get stiff if not moved. I have tried to be (and think I have) careful of not banging it or putting any pressure on it when the splint is off. I don't sleep with it on, I'm afraid I might accidentally hit my husband with it.

Here are a couple of sights with more information (medical) on elbow bursitis:
Elbow Bursitis -- American Association of Orthopedic Surgeons
Olecranon Bursitis; Patrick M Foye MD and Todd P Stitik MD; eMedicine Article, November 22, 2006


Dreaming again said...

Ouch ouch owie owwe owwwwww!!!!

empathy & sympathy!!!


Dr. Smak said...

Good luck with your recovery! My advice is to take it easy as long as you can stand it - I have seen these be very slow to resolve when people jump back in too quickly.

rlbates said...

Thank you both. I'm trying very hard Dr Smak, but miss doing my pushups/chin ups for upper body strength.

denverdoc said...

Out of the blue bursitis...honestly that's the only kind I see in elbows. Those big ol' swollen bursae sure look bizarre. Hope yours shrinks to size in a hurry.

rlbates said...

Thanks, Female Doc. It's improving (too slowly).

Anonymous said...

Oh this is a weird coincidence!

I have this too and also no known "incident". Just showed up. Hugely and dramatically, a squishy golf ball sized thing dangling off my elbow.

Ick. I have no medical background but never heard of elbow cancer so decided to ignore it until it went away. It got bigger and bigger.

Went to the local diner and was diagnosed by the guy sitting next to me...

It IS going away now... maybe these things are spread by Scrabulous?

hope you are healing yourself!
yrs truly,

Sid Schwab said...

I remember draining a few when they got infected. I much preferred to let orthopods handle it. Sounds like you're getting better, which is a good thing. The world needs you.

rlbates said...

Laundress, it will get better. Thanks for all the concern from all of you. I'm touched.

Frank said...

I have popeye elbow also. I got it walking my 3yr old black lab/mix. She pulls the leash. I am training her not to pull though, and she is learning. I call my primary physician and said I needed my popeye elbow drained. The assistant called back to say,"you have to come in and get a referral, we don't do that here". I screamed that "that is what is wrong with the American Health care system". I told her I would do it myself.

Anonymous said...


I was looking up elevated temps in shoulder bursitis from google and I came across your blog.

I have a question for you, that is if you may know the answer being that you are a plastic surgeon and not an ortho. I was just recently diagnosed with bicipital tendonitis with some impingement and I am concerned that the last two visits to the primary care I had an elevated temp of 99.6. This is unusual for me. Mine is usually about 96. I do not have any swelling........but I do have warmth and a little bit of red in my shoulder and pain. Do you think it is possible that I have shoulder bursitis BECAUSE of the elevated temp.

Did you have an elevated temp with elbow bursitis.

Thanks if you can reply

rlbates said...

Anon (3-7-09), I did not have an elevate body temp, but had increased skin temp at the elbow. If you have an elevated temp with redness, swelling in or around a joint you need to have it checked.

Anonymous said...

Hello I am a french plastic surgeon and also had elbow bursitis since august diagnosed infected. I have had antibiotics and rest but inflammatory local signs (redness, warm) are still present. What is your experience about it ?


rlbates said...

Anon (11/2012): so sorry to hear of your continued problems. I would leave this up to your txing surgeon who can actually exam you, but it may be you will need to have the bursa excised. Best to you