Elbow bursitis from contusion. Elbow bursitis: photos, symptoms and treatment

Date: 19.10.2019

ICD-10 code: M70.2 (bursitis olecranon), M70.3 (other bursitis of the elbow joint)

Elbow bursitis is a fairly common disease characterized by an inflammatory process in joint capsule elbow.

The elbow joint is a complex anatomical joint, in which there are three synovial bags: the radial-shoulder, ulnar subcutaneous, ulnar interosseous.

The bursa or bursa is filled with synovium from the inside, that is, cells that secrete articular (synovial) fluid. It acts as a lubricant to prevent wear on the articular surfaces. Sometimes inflammation develops in the bursa, pain and other symptoms appear.

Why does bursitis of the elbow develop?

Olecranon bursitis or olecranon bursitis is also called the student's elbow, since the disease most often develops in people whose professional activities are closely related to the emphasis on the elbows.

Stretching of the joints, their periodic congestion.
Injuries to the elbow, nearby tendons and periarticular bursa.
Arthritis and gout, which cause inflammation and affect the bursae.
Mechanical damage to the skin in the elbow area.
The penetration of microbes into the synovial bag of the elbow through the lymph or with the blood stream.
Constantly finding the elbow in the same position.
Violation of metabolic processes in the body.
Autoimmune diseases.

Types of ulnar bursitis

There are several types of ulnar bursitis.

Purulent

Infectious, or purulent bursitis of the elbow joint, arises from the cause of the penetration into the synovial bag of pyogenic microbes from purulent foci along lymph nodes or through blood.

With constant irritation synovial bursa in the elbow area, muco-serous exudate begins to accumulate in it, and the penetration of infection leads to the transformation of serous exudate into purulent. The patient observes reddening of the skin in the elbow area, an increase in temperature, limitation of limb mobility.

Acute bursitis

It manifests itself in severe pain, aggravated by movement. In the inflamed area, it is felt pain point, touching which leads to the spread of pain to the entire surface of the hand.

In an acute process of inflammation, the elbow swells and hurts. When feeling the joint, a fluctuation is determined, that is, the fluid fluctuates when pressing on the skin of the elbow.

Relapsing

Chronic (recurrent) bursitis is manifested by mild joint pain that lasts for a long time. The joint is not limited in movement, the tumor is not visible or felt, but when palpating, you can find some dense formation.

Recurrent bursitis occurs when damaged areas become reinfected. Any damage provokes an exacerbation of the pathology.

Post-traumatic bursitis

The disease develops during occupational stress on the elbow joint. After trauma, infection of the bursa with streptococcus, staphylococcus and other pathogenic organisms usually occurs.

If we ignore post-traumatic bursitis, then it will turn into purulent, then into the stage of exacerbation and cause acute bursitis of the elbow joint.

By the nature of the fluid accumulating in the bursa, the following are distinguished:

Serous bursitis, which is considered fairly mild and safe. The liquid has a whey consistency.
Hemorrhagic, when fluid accumulates in the cavity of the synovial bag along with blood.
Purulent, in which, as a result of the neglect of the case, the formation of pus occurs in the bursa. This species is considered dangerous as it can lead to sepsis and limb amputation.

Symptoms of the disease

Swelling of the elbow

It appears suddenly. At first, the swelling does not interfere normal life and limb mobility. But if you ignore this symptom, then the edema will gradually progress and the disease will turn into an acute stage.

Temperature increase

If the temperature rises simultaneously with swelling of the elbow, then this indicates inflammatory process, it is necessary to urgently consult a doctor.

Joint pain and change in its shape

You should pay attention to the symptoms of pain in the elbow joint if it appears suddenly, for no apparent reason. Also on additional symptom, such as the sensation of fluid transfusion inside the joint when flexing and extending the elbow, it can be understood that inflammation of the bursa develops.

Diagnostics

Before treating bursitis of the elbow joint, an orthopedic traumatologist is examined, who can easily determine the disease and its causes. But if there is no exact certainty, then the following studies are carried out:

x-ray. To determine the inflammatory fluid in the bursa of the elbow;
Ultrasound. Helps to determine how much fluid has accumulated in the elbow joint, allows you to make an accurate diagnosis and decide whether an operation is necessary;
MRI. It is rarely used, in the event that you need to know the degree of neglect of the disease.

Treatment

It depends on the stage of development of the disease.

Elbow immobilization

At the initial stage of ulnar bursitis, it is necessary to provide the hand with complete rest. Apply a fixation bandage directly to the elbow, but not too tight so that blood circulation is not disturbed. This can be done at home. It is necessary that the arm is in one position as in a fracture.

Medicines (tablets, ointments, injections)

Elbow bursitis is treated with pain relievers and anti-inflammatory drugs. Gels and ointments are used, for example, Diclofenac, Voltaren, Dimexide, Indomethacin.

In the acute phase or with chronic form bursitis, antibiotics and anti-inflammatory drugs are prescribed to reduce pain symptoms, relieve inflammation. Ibuprofen, Movalis, Dikloberl, Diclofenac are prescribed orally in the form of tablets.

Used injections of drugs that have anesthetic, resorption, anti-inflammatory effect. Corticosteroid treatment is prescribed. This helps to remove inflammation, reduce the amount of fluid in the synovial bag.

If hemorrhagic or purulent bursitis of the elbow joint is diagnosed, antibacterial treatment is prescribed. Antibiotics are prescribed wide range from the group of macroliths, penicillins, cephalosporins. These are Ampicillin, Cefix, Fromilid, Cefazolin. Antibiotics are used both as pills and injections.

Most often, Dimexide is used as a primary agent. It is diluted in boiled water in a ratio of 1 to 4. In the resulting solution, a cotton cloth is moistened and applied to the elbow. Insulate with polyethylene and woolen cloth.

Dimexide is used for compress, diluting in a ratio of 1 to 1. But the medicine has many contraindications and can harm the body. Dimexide can be diluted with novocaine in a ratio of 1 to 3.

The compress should not be kept for more than 40 minutes. If there is a burning sensation, it must be removed. The course is not more than 10 days. Sometimes Dimexide is used as an antibiotic agent. Then in his water solution pour in dry antibiotics and apply to the skin.

Dimexide has the ability to draw out pus from the wound surface and is excellent for initial treatment bursitis at home. It easily penetrates tissues and blood through intact skin.

Dimexide is a universal solvent, enhances the passage of many drugs, has anti-inflammatory, antimicrobial effects. Dimexide activates antibiotics and speeds up the healing process.

Physiotherapy

During the period of remission, physiotherapy is prescribed. It includes: ultrasound, acupressure, acupuncture, balneotherapy, UHF, magnetotherapy, paraffin, ozokerite, phonophoresis with hydrocortisone. Physiotherapy helps to eliminate inflammation, improve metabolic processes in the bursa.

Operative treatment

If the bursitis is acute, purulent, chronic, then it is required surgery... There are several types of operations.

Puncture

During the operation, the synovial bag is cut, cleansed of pus, washed with saline. Then processed antiseptic agents, inject antibacterial injections under the skin and suture the wound.

Drainage

Used for bursitis of a complex course. The bursa cavity is opened and drained with a tube. The drainage is left until the joint inflammation subsides.

Bursectomy

The operation consists in excision of the ulnar bursa followed by the application of a splint to ensure joint rest.
The operation allows the most effective treatment of elbow bursitis. Conservative treatment effective for non-infectious bursitis.

Therapy with folk remedies

As complementary treatment treatment with folk remedies at home is well suited. Folk remedies cannot cure olecranon bursitis, but they help well to eliminate some of the causes and symptoms of the disease.

Cabbage leaf

Cut the veins from the cabbage leaf, beat off the leaf until the juice appears. After that, the sheet is applied to the elbow and insulated. Every 4 hours you need to replace the leaf with a fresh one.

Compress with lard

At home, the diseased limb is steamed and a piece of unsalted bacon is tied to it. Leave the compress overnight. Lard helps soothe pain, relieve inflammation by its ability to draw out toxins. The application of the compress is possible within 2 weeks.

Beekeeping products

To remove the symptoms of the disease at home, you can use propolis alcohol tincture or ointment based on it. It is necessary to moisten a clean cotton cloth in it, apply it to the sore elbow and wrap it in a warm woolen cloth.

At timely treatment elbow pain decreases in 3, maximum 6 weeks. If an operation has been performed, then the functionality of the joint is restored a couple of weeks after the operation. Scar tissue can form within a year after surgery.

Therefore, timely identified causes and symptoms of the disease, referral to a specialist are the key to a quick recovery.

Bursitis – inflammatory disease forming in the bursa of the joint. In this situation, we mean inflammation of the intra-articular sac of the olecranon. Near each joint there are synovial bags containing liquid inside. They are needed for shock absorption (separation of the articular surfaces) and protection of joints from various injuries.

The knee is considered the most traumatic area, followed by the elbow joint. The latter contains 3 bags, each of which contains a certain amount of fluid (ulnar subcutaneous, interosseous ulnar, interosseous).

Bursitis of the elbow called inflammation of one of these bags. In ICD-10 this ailment assigned code 70-71.

Causes

The following reasons contribute to the formation and progression of elbow bursitis:

The main factor leading to bursitis is any arthritis(rheumatoid, gouty, psoriatic). As a result of a fairly strong inflammation in the cartilage itself or in the synovial bag, an accumulation of fluid forms, which is the reason for the formation of elbow bursitis.
Ingress of infection into the body often leads to bursitis. Most often this happens if the periarticular tissue was deformed next to the bursa, and harmful microorganisms and bacteria appeared in the wound. Elbow bursitis can cause panaritium. With such an infectious inflammation, the soft tissues of the fingers and bones are affected. In some cases, the infection can get into the synovial bag "from the inside", i.e. transfer with the help of blood (hematogenous pathway) or lymph (lymphogenous pathway).
A rare factor in the development of bursitis - microtrauma... Due to the repeated repetition of the same movements, the elbow joint is injured. This disease most often occurs in people whose work is related to the support of the elbow on a hard surface. These are, for example, chess players, students, engravers, draftsmen. Such people are exposed to inflammation of the subcutaneous ulnar bursa, and in tennis players, for example, the pathology of the interosseous ulnar bursa is more often observed. This discrepancy is caused by the peculiarities of the distribution of the load on the elbow, from which it follows that the places of occurrence of microtraumas are different.
In some cases after purchase mechanical injury elbow bursitis does not develop immediately, but after a while. This happens when a person hits or falls on a given part of the body. It is extremely rare to find out the origin of the elbow bursitis.

Also among causes of inflammation in the elbow joint secrete some chronic diseases (diabetes mellitus, etc.). Failure of the metabolic process, low immunity, taking steroid drugs can also lead to the development of bursitis of the elbow joint.

Classification

Like most inflammatory diseases, elbow bursitis can be acute, subacute and chronic... An important fact is that each type of bursitis stands out depending on which of the bags has undergone deformation. The quality of the fluid contained in the damaged bursa also matters.

Thus, the following types of bursitis are distinguished:

serous;
hemorrhagic;
purulent;
fibrous;
mixed.

Elbow bursitis symptoms

To signs of acute serous-homorrhagic or serous bursitis elbow joint include:

mild pain, swelling, redness, fever in the area of inflammation;
Difficulty moving around the elbow
a spherical protrusion significant for the eyes, soft to the touch, may occur;
in general, the state of the body remains unchanged, however, in some patients, body temperature rises, malaise and general weakness are noted.

Among the symptoms purulent bursitis elbow joint experts note:

sharp, twitching or bursting pain sensations;
the stronger the inflammation, the more palpable the pain;
the elbow becomes hot to the touch, swells, there is an excess of blood in the skin (hyperemia), when pressed with fingers, the pain increases sharply;
severe difficulty in movement of the elbow joint, the lymph nodes around it are enlarged;
symptoms characteristic of poisoning appear: weakness in the whole body, a broken state, headache, irritability, excessive sweating, body temperature rises to 38-39 degrees.

It takes much longer than an acute one chronic ulnar bursitis, having the following symptoms:

slight pain while moving;
discomfort in the area of the elbow joint;
movement in the joint is almost not difficult;
the area of inflammation looks like a dense formation.

First aid

If a patient has an acute non-suppurative bursitis, it is necessary to help him as follows:

To reduce edema, apply a tight pressure bandage that does not interfere with arterial circulation.
Tie a fixing scarf (orthosis) that supports the hand with the inflamed area.

It is forbidden carry out these actions with purulent elbow bursitis, because under pressure there is a risk of pus entering the tissue and blood vessels located in the immediate vicinity. With this type of disease, it is recommended to use medications in the treatment of elbow bursitis.

Diagnostics

The patient is examined by an orthopedic doctor who can easily establish the correct diagnosis. However, in order to understand the extent of the spread of inflammation and exclude possible complications, there are the following types of diagnostics:

radiography joint, which will help to identify the existence of a pathological process in the joint;
Ultrasound the joint will clarify the scale and location of the inflamed bursa and the amount of exudate in it;
MRI of the joint is used to diagnose bursitis of deep bursae.

Identification of the disease in the early stages of its course will allow timely initiation of adequate treatment of elbow bursitis.

Effects

It is important to note that complications of elbow bursitis are much more difficult to cure than the disease itself. Complications are the melting of the walls in the synovial cavity and the spreading of the pathogenic mass to nearby areas. The lack of timely assistance from a specialist and bringing the ulnar bursitis to severe stages contribute to the development of various complications.

The table presents possible consequences diseases:

Elbow bursitis treatment

During the treatment of chronic or acute bursitis of the elbow joint at home, it is possible to use anti-inflammatory drugs such as Ibuprofen, Voltaren, Diclofenac. Also help antibacterial drugs, which are selected, taking into account the sensitivity pathogenic microorganisms.

For treatment of mild shape diseases, it is possible to use gels and ointments that have an anti-inflammatory effect. However, it is worth remembering that they can only help if they are combined with the use of drugs, which are mentioned above.

Glucocorticoid preparations are used when the inflammatory process is pronounced. They are injected inside the inflamed joint capsule.

Do not forget that only qualified doctor... Trying to find a medication on your own or with the help of a pharmacist can put you at risk of serious complications.

Physiological therapy

After acute stage ulnar bursitis is overcome, to the system treatment procedures bring in physiotherapy. Pain syndrome fades away already in the first procedures. The following physiological procedures can be helpful for those suffering from bursitis:

massage;
magnetotherapy;
laser therapy;
mud treatment;
paraffin heating;
bischofite wraps;
physiotherapy.

During the treatment of elbow bursitis at home, it is recommended to follow a diet. Should be excluded a large number of salt in food, and also minimize intake meat broths, but boiled meat should be included in the diet, because this product will be useful during treatment. A daily intake of fruits and vegetables is also recommended.

Folk remedies

Sometimes people with bursitis of the elbow joint, in addition to specialized ointments and gels (Voltaren, Dimexid, Indomethacin, Diclofenac, Traumeel S), use folk remedies.

Correctly selected means traditional medicine used at home can have analgesic and anti-inflammatory effects.

For the proper effect, these procedures must be carried out regularly, their duration is several weeks.

Compress with propolis tincture:

20 gr. mix propolis with 1 glass of quality vodka.
Mix the resulting liquid, let it brew for 1 week.
After 7 days, the resulting product must be applied to gauze or bandage, applied to the affected area for 5-10 minutes.

Repeat the treatment daily for several weeks.

Cabbage leaf compress... The method may be useful not only for bursitis, but also for arthritis:

The sheet must be washed, the sinewy part cut out.
Then it needs to be chopped or beaten off until juice appears.
After that, attach the sheet to the inflamed area, bandage, insulate soft cloth... The cabbage leaf reduces pain and, as it were, "draws out" inflammation.
After about 30 minutes, the leaf will become dry and hot, now you need to replace it with a fresh one.

This tool can be used constantly, because it has no harm.

With acute elbow bursitis burdock decoction able to relieve inflammation.

Method of preparation and use:

2 tbsp. tablespoons of finely chopped burdock root boil in 1 liter. water for 5 minutes.
The broth should be infused for 10-15 minutes, then a compress should be applied to the inflammation focus.
For achievement better effect you need to place the inflamed joint in warmth: wrap it with a woolen scarf and let it warm up for an hour and a half.

Repeat these steps daily for a month.

Honey and aloe ointment

With purulent bursitis of the elbow joint, heating is prohibited, so this ointment is ideal for treating this form of the disease.

To prepare the ointment, mix 3 tsp. tender aloe pulp with 1 tbsp. l. liquid honey and 2 drops of tea tree ether.
Place half of the mass on gauze or bandage, apply to the inflamed area. Do not warm or wrap a sore joint.
After 50 minutes, you need to change the compress and keep the new one for the same amount.

The procedure must be carried out 20 more times or less, depending on the result. Honey and aloe ointment promotes healing of microcracks and wounds on the elbow, and also relieves swelling.

There are contraindications, it is necessary to consult a specialist.

Disease detected in time, as well as correct treatment ulnar bursitis will help preserve joint health. Cope with the disease is able an integrated approach to treatment, consisting of the use of medications, traditional medicine and physiotherapy. Elbow bursitis often becomes chronic disease, accompanied by significant pain, therefore, it is absolutely impossible to postpone treatment.

Surgical intervention

Usually, treatment of elbow bursitis involves only the use of medications. In case of complications and the appearance of pus in the articular bag, the patient may need surgical intervention. The patient is pumped out fluid and injected into the joint anti-inflammatory and antibacterial agents... Sometimes it becomes necessary to remove the deformed bursa. All types of operations associated with bursitis are not difficult, and patients will soon be able to return to their normal rhythm of life.

Prevention of bursitis

Exists following measures to prevent the development of bursitis:

exact adherence to the regime of work and rest;
correct distribution of physical activity;
fast and quality treatment infectious diseases;
treatment of pathology in the initial stages is important to prevent the appearance purulent stage;
avoid injury to areas of the body where the synovial capsules are located;
the use of protective equipment when there is a threat of injury;
disinfect any injuries with hydrogen peroxide, an antiseptic: scratches, cuts, abrasions, abrasions.

Bursitis is enough serious illness... If you do not pay attention to the symptoms in time elbow bursitis and do not take up treatment, there is a risk of complications and severe forms this ailment.

The articular surfaces of the elbow are closed with a kind of capsule - a bag (in Latin: bursa), the role of which is not only external protection of the joint, but also to mitigate friction between its components. The bag is filled with fluid, which provides proper lubrication to the joint. Sometimes an inflammatory disease of this capsule, the name of which is bursitis, can develop. Bursitis is especially common in the shoulder, elbow, and knee joints..

Purulent bursitis of the elbow joint: symptoms, treatment

The elbow is surrounded by several membranes that are not connected to the articular cavity. The largest is superficial, from the side of the protruding part of the elbow.

Cause, types and type of ulnar bursitis

Prepare the soil for bursitis:

Systematic arthritis of rheumatoid, gouty, psoriatic and other nature.
with synovitis - accumulation of fluid, leading to inflammation of the synovium
Constant irritation of the elbow when resting on the surface, as a result of daily monotonous movements. This danger is subject to:
- Chasers, engravers, leatherworkers
- Diligent assiduous students, etc.
Frequent mechanical injuries to the elbow during a fall, sudden amplitude movements:
- this is typical for professional tennis players, volleyball players, handball players

Causes of purulent bursitis of the elbow joint

Purulent inflammation of the bursa begins when the infection penetrates into the joint due to:

Elbow wounds resulting from trauma
Formed near the inflammatory focus:
- erysipelas
- subcutaneous phlegmon
- pustular skin lesions, etc.
Surgical intervention with joint hemorrhage
Specific diseases (tuberculosis, gonorrhea, syphilis, etc.)

Types of ulnar bursitis

Inflammation of the joint capsule of the elbow is classified according to three criteria:

anatomical location
type of inflammatory process
the nature of the course of the disease

Bursitis type

Serous - inflammation affects the intercavitary and cavity surfaces and occurs without the formation of pus inside the cavities
Purulent - pus and pathogenic bacteria (streptococci, staphylococci, etc.) accumulate in the bursa.
Hemorrhagic - the exudate of the articular cavity contains blood

The nature of the disease:

Acute, subacute and chronic.

Symptoms of suppurative ulnar bursitis

The usual serous form is accompanied by swelling of the elbow, painless on palpation. At the same time, the skin is not modified, and the elbow does not experience any particular difficulties in movement

Purulent inflammation is another matter. The following symptoms can speak of a purulent type:

Painful swelling and twitching occurs just above the elbow
The skin in the area of the swelling turns red and becomes hot to the touch
Body temperature can rise to high values
Joint movements are made difficult, but because of pain, and not because of a decrease in the true range of motion, as is the case with:
- pain with bursitis is superficial, and with arthrosis it is concentrated inside the joint
You should also distinguish between synovitis with arthrosis and bursitis:
- with synovitis (inflammation of the synovium), the elbow swells evenly
- with bursitis - clearly localized swelling
Possibly enlarged and inflamed lymph nodes (lymphadenitis) and cutaneous lymphatic ducts (lymphangitis), as is the case with bacterial infections

Purulent inflammation of the capsule, if left untreated, leads:

Symptoms of intoxication: nausea, headache, drowsiness and apathy
Formation of fistulas and phlegmon
For the chronic form of the disease:
- Permanent aching pains at the elbow
- One or more lumps are felt under the skin
Periodic exacerbations with all of the above symptoms

Elbow bursitis treatment

Diagnosis of bursitis

For diagnostics, laboratory and instrumental methods are used.:

Give up general analyzes blood and urine
Blood sugar test:
- Having diabetes can complicate the course of the disease and require a different treatment regimen
A puncture is performed, the purpose of which is to collect exudate:
- Such an analysis is important for the selection of a drug for antibiotic therapy. purulent inflammation handbags
To differentiate arthrosis, X-ray or ultrasound can be performed

If serous inflammation of the membranes can somehow go away on its own, then this rarely happens with purulent bursitis.

But usually any form of this disease does not need to be left to chance.

Video: Puncture of the elbow joint with purulent bursitis:

Serous bursitis treatment

With a non-purulent nature of inflammation, treatment is usually limited:

Elbow immobilization with a kerchief
Removal of exudate accumulated between the membranes by puncture and washing
Applying a tight bandage
Physiotherapy:
- warming procedures
- electrophoresis, UHF, UST, etc.

Conservative treatment of purulent bursitis

With a purulent form of bursitis, first of all, it is necessary to eliminate the abscess of the articular bag itself.

Liquid is aspirated with a syringe, immediately relieving the condition
Antibiotic therapy is prescribed
They are treated with anti-inflammatory non-steroidal drugs(nimesil, diclofenac, ibuprofen) and corticosteroids

Operation for purulent bursitis

Surgical treatment is necessary when:

Types of operations

Conventional bursitis surgery is simple and takes place under local anesthesia:
- A thick needle is inserted into the joint capsule, through which the accumulated exudate is evacuated
- Complete pumping out of the liquid is performed using a catheter with a rubber bulb at the end
Another type of operation is partial excision of the joint capsule
Radical surgery - complete bursectomy is performed in case of recurrence of purulent bursitis

Prevention of ulnar bursitis

In order to prevent the purulent stage of inflammation of the articular bag, it is necessary:

Avoid permanent elbow injury:
- protect the elbow with a pad (support) during sports activities
- put something soft under it when sedentary desk work or study
Timely heal wounds on the elbow surface
Eliminate specific chronic purulent processes

Attention:

Most often, the cause of long-term pain in the elbow is not arthrosis or bursitis, but epicondylitis, inflammation of the attachment point of the elbow tendons, which can be healed on its own.

The video below will tell you more about epicondylitis of the elbow joint.

Video: What is epicondylitis

P. S. We do not even suspect that many diseases are treated much easier than those written about them medical myths... Dr. Sperling tells about many secrets of treating diseases of ADS and not only, as always with authority and humor.

When diagnosed with elbow bursitis, the symptoms and treatment of the disease depend on its severity and on the presence of comorbidities. Many people ignore the first signals of the body about malfunctions. Soreness on movement and mild swelling are often not cause for concern. However, it was early diagnosis and timely therapy allow you to quickly cure bursitis. Its chronic form reduces the ability to work and significantly impairs the quality of life.

Description of the disease

Elbow bursitis is a disease characterized by an inflammatory process in the synovial bursa and the accumulation of exudate in it. Latin name synovial bag - bursa synovialis gave the name to the disease. Its international code for ICD 10 is M 70.3. Bursitis refers to soft tissue diseases associated with stress, overload and pressure.

Exudate is the fluid that forms during the development of an inflammatory reaction. It is rich in protein and contains blood cells. The synovial bursa is a slightly flattened cavity - a sac. It attaches to the bones forming the joint near the edges of the articular surfaces or at some distance from them. The bursa hermetically covers the joint, protecting it from mechanical stress and infectious lesions. The bursa is separated from the tissues surrounding the joint by a capsule and filled with synovial (articular) fluid.

From the inside, the synovial bag is lined with a synovial membrane. The matrix of the synovium is based on collagen fibers and elastic networks. They form a thin fibrous carcass. The upper covering layer of the synovium is organ-specific to the joint. Its cells (synoviocytes) produce hyaluronic acid. This component of the synovial fluid gives it lubricating properties.

The elbow joint is represented by three bones - the humerus, radius and ulna. It is formed from three simple joints:

brachio-ulnar;
brachioradial;
proximal (located closer to the center of the body) radioulnar.

The elbow joint contains:

subcutaneous bag of the olecranon;
ray-arm;
interosseous ulnar.

All three bursae are located in the joint capsule, which is common to all three bones.

Bursitis of the elbow provokes the deposition of salts on the walls of the articular sac. The synovial fluid contains a significant amount of calcium salts. They help the cartilage maintain its elasticity and promote the rapid healing of microtraumas. With the development of inflammation, calcium salts accumulate and are deposited in the form of dense formations. Calcium deposits cause joint dysfunction.

Infectious and aseptic types of bursitis

Traumatic bursitis is caused by trauma. The inflammatory process occurs immediately after the fracture or. Ligament rupture can provoke an ailment.

Post-traumatic inflammation in the synovial sac develops against the background of changes caused by trauma. The disease is often diagnosed at the stage of rehabilitation after an injury.

Traumatic and post-traumatic bursitis is referred to as aseptic type. In the aseptic form, infectious agents are not detected in the articular cavity.

Infected bursitis appears after the penetration of pathogenic microorganisms into the bursa. Most often, inflammation of the synovial sac of gonococcus and staphylococcus is provoked. Antibiotics for bursitis of the elbow joint of an infectious nature are a mandatory component of therapy.

Infectious bursitis is divided into specific and non-specific. Specific include diseases caused by gonorrheal, brucellosis, tuberculosis and syphilitic infections. When diagnosed with elbow bursitis, how to treat depends on the type of infection.

Classification of the disease by the form of its course

Elbow bursitis is distinguished by its clinical course. They are acute, chronic, and recurrent.

The acute form of the course is characterized by vivid symptoms, increased body temperature and intoxication. Severe inflammatory reactions can cause disruptions in performance internal organs... Acute forms of the disease usually go away on their own in 1-2 weeks. But repeated trauma can make the condition chronic.
The chronic process is accompanied by mild symptoms. They are observed over a long period.
With a recurrent form, the disease proceeds with periodic exacerbations. Exacerbations can be triggered by injury, infection, or physical overload.

Varieties of bursitis by the nature of the exudate

There is an additional classification of ulnar bursitis by the nature of the exudate.

Inflammations of the synovial sac are: serous, purulent, fibrous and hemorrhagic.

Photo. Subcutaneous swelling with bursitis of the elbow joint

Serous bursitis of the elbow joint occurs on initial stage diseases. In the process of inflammation, a large amount of exudate is released. By its characteristics, serous exudate resembles synovial fluid. From an excess of internal fluid, the bursa inflates and begins to resemble a subcutaneous tumor (as in the photo). Sometimes the diameter of the swollen bursa exceeds 8 cm.
diagnosed when pyogenic microorganisms are found in the exudate. They can penetrate into the synovial cavity through small abrasions on the skin along the lymphatic pathways from a nearby focus of pyogenic infection (boil, carbuncle). Sometimes pus can spread outside the bursa, causing purulent arthritis or phlegmon (melting of adjacent tissue).
Fibrous effusion is characterized by the presence of fibrin (the protein that forms a blood clot).
Hemorrhagic exudate has a reddish tint because it contains red blood cells. They enter the fluid from the destroyed blood vessels. Hemorrhagic bursitis often results from trauma.

There are also mixed types of bursitis (serous - fibrous or purulent - hemorrhagic).

Why does bursitis of the elbow develop?

Wherever bursitis of the elbow arises, the causes are mainly associated with regular physical activity... The disease is usually found in people who put a lot of stress on the joint during sports training or in the process professional activity... Regular physical overload is accompanied by minor injuries, which over time start the pathological process in the joint.

The disease develops in people who are forced to perform monotonous actions with the elbow joint. It is diagnosed in:

gardeners;
draftsmen;
drivers;
bakers.

Students and pupils who are forced to rewrite a large number of texts by hand complain of inflammation of the synovial sac. The disease occurs in programmers and pianists.

In this case, the subcutaneous synovial bag of the olecranon is usually affected. It is located at the point where the skin is taut the most when the elbow is bent. Less commonly diagnosed bursitis of the shoulder bag. Such inflammation is more often found in athletes performing movements with the help of the elbow joint (tennis players, basketball players, hockey players, javelin throwers, boxers).

The likelihood of developing the disease increases with age. The pathological process provokes endocrine, inflammatory and autoimmune diseases, often occurring after 45 - 50 years:

gout;
rheumatoid arthritis;
systemic lupus erythematosus;
scleroderma;
psoriasis;
Crohn's disease;

Negatively affects the condition of the bursa:

prolonged hypothermia;
poisoning;
overweight;
allergic reactions.

At allergic reaction a large number of antibodies arise. In the acute phase of the immune response, inflammatory mediators are released and the inflammatory process is triggered.

How does the disease manifest

The main symptom of elbow bursitis is edema. It occurs very first and most of all worries the patient. Sometimes the synovial bag of the joint, stretched from excess exudate, is the only manifestation of the disease. If the disease progresses, the joint swells, and its capsule clearly protrudes outward.

The swelling is clearly visible in the elbow area when the arm is extended. Depending on the stage of the disease, the swollen bursa can resemble a small pillow, a plum, or an apple in shape and size. The skin in the area of the focus of inflammation sometimes turns red. Redness indicates an infectious or autoimmune nature of the disease.

Deformation of the elbow joint forces the sick person to hold the arm in a forced bent position. He is not so much hindered by a stretched synovial bag as by pain. It can be shooting, aching, or throbbing. Often, pain is given to the hand. They intensify during a night's rest. The stronger the inflammation, the more intense the pain. It hinders movement, not allowing the elbow to bend. Motor activity is also impaired due to the deposition of calcium salts.

If the inflammatory process has not gone beyond the synovial bag, an increase in temperature and intoxication, as a rule, is not observed. With a severe form of the disease, the elbow and axillary lymph nodes may increase and become painful.

Drug therapy of the disease

If elbow bursitis is suspected, treatment should begin with immobilizing the hand. The articulation is fixed using pressure or gusset orthopedic dressings. For severe injuries, a plaster cast can be used. Sometimes, after a short period at rest, the pain in the elbow joint subsides on its own, drugs is not required.

If the edema is small, Vishnevsky ointment or Finalgon, Fastum, which increase blood circulation, are used to reduce it. Medicine applied to the inflamed joint. In the acute form of the disease, it cannot be used. It can cause increased swelling.

Non-steroidal anti-inflammatory drugs (NSAIDs) are used to relieve pain and reduce inflammation. If a small amount of fluid has accumulated in the synovial sac and there is no severe pain, external medications are used in the form of ointments (Ibuprofen, Diclofenac). They are applied to the inflamed joint (if on skin no open wounds).

When the symptoms are pronounced, the patient takes NSAIDs by mouth. The tablet is taken after meals to reduce Negative influence on the digestive system.

Treatment of bursitis of the elbow joint is carried out with the help of:

Diclofenac;
Ibuprofen;
Ketoprofen;
Nimesulide.

In the first days of therapy, and intramuscular injection... They are recommended for patients with gastrointestinal pathologies - intestinal tract. Severe pain eliminated by intra-articular injections of NSAIDs or hormonal drugs. Doing them yourself is prohibited. An intra-articular injection can only be entrusted to an experienced surgeon. Antibiotic treatment is prescribed exclusively for purulent bursitis.

After stopping the acute process, physiotherapy is used:

dry heating;
ultraviolet radiation.

UHF - procedures are carried out simultaneously with drug treatment. Sometimes used radiation therapy in order to achieve an analgesic and anti-inflammatory effect.

To speed up recovery, the patient is prescribed vitamin complex, calcium medications and immunostimulating medications. Calcium deposits are dissolved with magnesium preparations.

Operative treatment

In case of severe exacerbation, exudate is removed from the bursa with a syringe (aspirated). Aspiration is carried out exclusively under sterile conditions. After removing the exudate, the bursa is injected hormonal drug, relieving inflammation (Kenalog).

If purulent bursitis is found, drainage of the synovial cavity is used. During surgical intervention make a small incision in the wall of the bursa. Through the hole made, the exudate freely comes out. Sometimes a tube is inserted into the wound so that it does not close and does not interfere with the outflow of fluid.

While drainage occurs, the patient is monitored in the hospital. Washing of the drained cavity may be prescribed. The duration of drainage and the number of flushes is determined by the attending physician, depending on the severity of the disease.

In advanced cases, when the pathological process develops long time, the walls of the bursa change, thicken and form folds. The deformed joint becomes permanently inflamed and makes it difficult to carry out daily work. How to treat ulnar bursitis in such cases, the doctor will tell you. Bursectomy (removal of the bursa) may be recommended. During the operation, the bag is removed, the surface of the olecranon is smoothed and the skin is sutured. During rehabilitation, a new bag is formed in the elbow joint.

Or bursitis of the elbow is one of the most common diseases of the human musculoskeletal system.

What is an elbow?

This is the junction of three bones: the humerus, ulna, and radius. The complex anatomical connection is "hugged" by 3 articular bags, inside which there is a lubricant, or synovial fluid. Bags - in Latin "bursa" - are needed so that there is no friction between the bones.

The amount of synovial fluid in the bags is strictly limited, it should only be enough to lubricate the surfaces. Excess fluid is one of the signs of impaired function. For any cause of the disease, treatment for elbow bursitis is aimed at elbow joint moved without difficulty. When moving, there should be no crunch, pain and discomfort.

Why are elbow bags inflamed?

In terms of frequency, the causes of inflammation are as follows:

Repeated trauma of the same type. Most often, the joint is damaged if body weight is regularly transferred to the elbow. This applies to athletes, miners, loaders, students. This is how the "miner's elbow" and other inflammations associated with professional activities develop.
Acute injury - for example, falling on the elbow in ice.

Inflammation of all joints of the body, arthritis of various origins as well as gout.
Abrasions or cuts in the joint area when the infection enters from the outside.
For an unknown reason. In this case, treatment of elbow bursitis begins with a clinical examination, which allows you to find the cause of the disease.
With general heavy infectious diseases- tuberculosis, syphilis, brucellosis, gonorrhea, erysipelas.
With other heavy systemic diseases - diabetes mellitus, rheumatism.
In bedridden patients or in deeply old age.

How does elbow bursitis manifest?

This condition can be suspected if:

the joint area is sharply swollen, increased in size, the swelling gradually increases;
worried about joint pain, which increases with movement;
the joint is hot to the touch;
redness is visible above it, which can spread far around;
a fever begins;
weakness, malaise, chills appear, appetite disappears.

If at least one of these signs appears, you should immediately consult a doctor in order to start treatment of elbow bursitis on time. The earlier it is started, the better the chances of a full recovery.

What happens if bursitis is left untreated?

There will be complications, since this disease cannot "pass" on its own. The blood supply to the joint capsule becomes poor, the infection settles there firmly. There may be suppuration that spreads to adjacent tissues. Pus from the inside can break through all tissues, resulting in a fistula or non-healing opening. In place purulent process adhesions may appear, due to which the joint becomes immobile. Acute inflammation can take on a chronic form, in which pain and fever will bother you constantly. All this can be avoided if the treatment of bursitis of the elbow joint is started from the first days of the disease. You need to contact a traumatologist or orthopedist, they are the main specialists in bursitis.

Can bursitis be treated at home?

It is possible if the disease was the result of a bruise, but general state at the same time does not suffer. The first thing to do is to apply a tight bandage over the joint. This is necessary in order for the joint to rest, and the movements in it are limited. It is recommended to bandage the hand in a bent position at an angle of 90 °. After bandaging, the hand must be fixed in a kerchief thrown over the neck. The arm should hang from the bandage. When bandaging, it is important not to pinch any blood vessels. The fingertips should be sensitive. If they are numb, the bandages should be loosened. Ready-made sports dressings are perfect for this procedure.

Elbow bursitis can be cured at home. Treatment: anti-inflammatory and analgesic ointments. A napkin is applied to the joint with any anti-inflammatory ointment that can be found in the pharmacy. The range of such drugs is increasing every year.

Antibiotics can only be prescribed by a doctor.

Sometimes the inflammation of the joint capsule is so aggressive that simple means they can't cope with it. There is a simple rule: inflammation should subside after 3 days from the start of treatment.

If this does not happen, and the condition only worsens, an urgent need to go to the doctor. When the doctor confirms the elbow bursitis, antibiotic treatment should be started immediately.

The choice of this or that drug depends on many factors: the severity of the process, the patient's age, concomitant diseases. Dosage form- pills, injections, gels, ointments or irrigations - the doctor also chooses.

What factors determine the choice of drugs?

First of all, from the form of the disease, which can be as follows:

Serous - a lot of fluid forms in the joint, but no bacteria.
Hemorrhagic - blood poured into the cavity of the articular bag.
Purulent is the most severe form when pyogenic bacteria have entered the joint.

Elbow bursitis. Treatment

Photos of people suffering from bursitis of the elbow joint clearly show what complications can arise if treatment is not started in a timely manner.

Sometimes medication isn't enough. This happens when too much fluid has accumulated in the joint. The bursa cannot stretch and the pressure of the fluid causes unbearable pain. To relieve the condition, the doctor may perform a puncture. The bag is gently punctured with a needle and the inflammatory fluid is aspirated. In some cases, this liquid is sent for research to a laboratory in order to find out more exact reason acute pain sensations. Without removing the needle from the cavity, the medicine is immediately injected into it, and the patient's condition is instantly relieved. Fast-acting medications are usually injected.

Can purulent bursitis be completely cured?

Not always, although every doctor strives for this. Much depends on the general reactivity of the patient's body. When purulent bursitis of the elbow joint is detected, the treatment is always complex. Isolated bursitis, when the whole body is healthy, and the person is young and full of strength, most often it is possible to heal without a trace. With concomitant diseases, the prognosis worsens.

If necessary, the doctor may prescribe the following studies:

X-ray of the joint to determine the condition of the bones.
Ultrasound of the joint to detect changes in the joint capsule: the presence of cavities, the nature of their contents.
General clinical examination: blood and urine tests, glucose levels, antibiotic sensitivity, and so on.

During treatment, it is necessary to completely get rid of pathogenic bacteria in order to improve the general condition of a person. Quite often, with purulent bursitis, you have to cut the joint cavity and install a drainage there so that the purulent discharge has an outlet. Along the incision, the joint cavity is washed with antiseptics and antibiotics, accelerating recovery.

Bursitis of the elbow in common diseases

If bursitis of the elbow is a complication of another common disease, such as diabetes, tuberculosis or erysipelas, then all efforts are directed towards eliminating the symptoms of the underlying pathology. Elbow bursitis, the symptoms, the treatment of which is entirely related to the general clinical picture, requires immediate therapeutic action. Remember that fighting the underlying pathogen and underlying disorder in a timely manner will always lead to recovery.

All people with severe common diseases it is better to prevent the development of bursitis than to try to cope with it later. Elderly people should be protected from injury, and bedridden patients should be turned over in bed more often. A good functional bed can significantly improve the quality of life of these patients.

Will folk remedies help?

Only when mild form when there is no pus or blood in the joint, wraps are performed fresh leaves medicinal and vegetable plants, lotions with propolis, pine baths and other available procedures of warming and resorbing action.

The result will always be better if you start early treatment bursitis of the elbow joint. Medicines for this should only be selected by a doctor. To calm inflammation, not only antibiotics are used, but also non-hormonal anti-inflammatory drugs, and in advanced cases, corticosteroid hormones are prescribed. From any folk remedies you need to refuse if a purulent process has begun.

What to do if bursitis becomes chronic?

It is necessary to persistently continue the treatment, achieving persistent and long-term remission... In the chronic form, inflammation is less acute, most often there is no fever and severe edema. But the chronic process causes joint stiffness, which is very difficult to cope with.

If chronic bursitis of the elbow arises, treatment must include physical therapy. To date, a large number of medical devices have been created that generate ultraviolet light, ultrasonic waves or ultra-high frequency current. All these methods of physical influence are successfully used in the chronic form of bursitis.

Phonophoresis also has an excellent effect, by means of which the medicine is carried into the thickness of the skin by ultrasound. Acupuncture gives excellent results, especially if it is performed by a highly qualified specialist.

In recent years, shock wave therapy has become very popular as a method of getting rid of chronic pain. The medical device generates an acoustic wave, the power of which is sufficient to destroy pathological formations. With shock wave therapy, adhesions, seals and scars are perfectly absorbed, and the mobility of the elbow joint is greatly increased.

Always after inflammation, the elbow joint needs to be developed; physiotherapy exercises are intended for this. They usually start with simple swinging of the hand, gradually bringing the range of movements to the usual level. It is important to do simple exercises daily. Massage or passive exercise is very helpful.

Correct, complete and specialized treatment helps to achieve either a complete cure or a significant improvement in the condition of the elbow joint.