Ulnar bursitis

Ulnar bursitis (bursitis of the ulnar sac, bursitis of the elbow joint) is an inflammation of the ulnar sac, which is located between the skin and the ulnar process of the ulna.

The bag is located on the back surface in the area of the elbow joint. With inflammation, inflammatory fluid appears in the bag, and the walls of the bag thicken and become painful. Bursitis of the elbow bag can cause a number of problems due to limited function of the elbow joint.

 
Causes of ulnar bursitis (bursitis of the elbow bag, bursitis of the elbow joint)

The causes of inflammation can be different: from a banal injury to an infection. According to the classification, septic (infectious) and aseptic (inflammatory) bursitis are distinguished. The elbow bag is characterized by both types of bursitis.

In some cases, the elbow bag may be damaged as a result of a direct injury mechanism, such as hitting or falling on the elbow area. The injury causes tears in the tissues of the ulnar sac and hemorrhage in the cavity of the ulnar sac. In some cases, blood can completely fill the cavity of the ulnar Bursa and the bursa can swell, as a result of which the elbow joint takes on a characteristic shape.

It is believed that blood accumulated in the cavity of the elbow bag triggers an inflammatory reaction. As a result of inflammation, the walls of the elbow bag thicken, become less elastic, and their sliding properties disappear. As a result, bursitis of the elbow bag develops.

Bursitis of the elbow bag can occur due to constant pressure on the elbow joint area. Some people do their work by resting their elbows on a hard surface.

If the elbow is constantly injured, this leads to the development of inflammation, and bursitis of the elbow bag develops. Bursitis of the elbow bag can be caused by an infection. A small scratch or prick in the area of the elbow bag can lead to infection. Or, after an injury, the infection can enter the damaged tissues of the elbow bag with blood flow from a source of chronic infection in the body, for example, a carious tooth.

The infection leads to the accumulation of pus in the cavity of the elbow bag. The consequences of infectious ulnar bursitis can be quite serious.
 
Symptoms of ulnar bursitis

Bursitis of the ulnar sac is manifested by pain and swelling in the ulnar process. When examined during palpation, the elbow bag is painful. In this condition, it is very painful to put your hand with your elbow on a hard surface.

If bursitis of the elbow bag does not go away for a long time, then the inflammation becomes chronic. There may be a feeling that lumps have appeared in the elbow bag in the inflammatory fluid.

This suggests that the elbow bag in response to chronic inflammation has become even thicker and folds have formed. These folds feel like lumps.
 
The elbow bag can increase in size several times. This is due to the thickening of the walls of the ulnar sac and the filling of the ulnar sac with inflammatory fluid. The amount of inflammatory fluid is usually associated with the inflammatory phase. If the inflammation is in the active phase, then the amount of inflammatory fluid increases and the bag increases in size. With a large size of the elbow bag, the elbow joint takes on a characteristic appearance when viewed from the side.
If an infection of the elbow bag occurs, the elbow becomes swollen, very painful, and warm to the touch. In this case, in addition to local signs of inflammation (pain, redness, increased local temperature, edema), general ones develop - fever, chills, changes in the blood test.

Emergency surgical intervention is required-opening and drainage of the elbow bag. If you do not consult a doctor and do not perform an autopsy of the elbow bag, the abscess may break through on its own, but systemic complications may occur.

Diagnosis of ulnar bursitis

Differential diagnosis of bursitis of the elbow bag is made with diseases such as gout, rheumatoid arthritis, septic arthritis of the elbow joint.
 
The diagnosis of bursitis of the elbow bag becomes obvious after examining the patient. The diagnosis is so obvious that no special examination methods are required, with the exception of an X-ray (image) of the elbow joint in the lateral projection.

An X-ray is needed not to establish a diagnosis, but to assess the condition of the ulnar process of the ulna. Sometimes, due to injury or chronic inflammation, an osteophyte (Bone Spike) forms on the ulnar process.

Osteophytes often additionally injure the elbow bag, supporting inflammation.

Radiography helps to decide on the choice of treatment method for bursitis of the elbow bag. If the osteophyte on the ulnar process is large enough, then it is advisable to perform surgical treatment of bursitis with osteophyte resection.

If it is not clear to the doctor whether bursitis is inflammatory or infectious, then a puncture of the elbow bag is performed and the resulting fluid sample is sent to the laboratory for research. Liquid cultures are performed to identify microflora and determine its sensitivity to antibacterial drugs.

So the doctor gets an answer to two questions: whether bursitis is infectious or inflammatory, and if bursitis is infectious, what antibiotic should it be treated with.

Treatment of ulnar bursitis

Conservative treatment.
Traumatic bursitis of the elbow bag can be treated conservatively. If a significant amount of blood has accumulated as a result of the injury, then a puncture is performed with a thick needle or a small incision is made to remove all accumulated blood from the cavity of the elbow bag. The question of the feasibility of a puncture is decided by the doctor.

There is a small risk of infection of the elbow bag during these manipulations, so the puncture is performed in the dressing room in compliance with all the rules of asepsis and antiseptics. After performing the puncture, a sterile dressing is applied.
 
Chronic bursitis of the elbow bag is a problem that can reduce performance and impair the quality of life. Swelling and pain are the main manifestations. Normal daily activities can cause discomfort. Treatment usually begins with an attempt to relieve the inflammatory syndrome.
Measures to relieve inflammation include rest in the elbow joint and the use of anti-inflammatory drugs. Medications such as diclofenac, Voltaren, and ibuprofen are used to relieve inflammation and swelling.
   
If there is inflammatory fluid in the bag, a puncture can be performed to remove the fluid and then examine it in the laboratory. During the puncture, provided that there are no signs of infection in the elbow bag cavity and there are no other contraindications, a small amount of a steroid agent, such as cortisone, can be administered.

Steroid medications are powerful anti-inflammatory agents. Its anti-inflammatory effect can last for several weeks.

You need to consult a physical therapist. A physiotherapist will help you choose physiotherapy procedures, taking into account all the features and contraindications.

The use of heat, cold, and ultrasound usually helps reduce pain and swelling. The use of cold or thermal treatments will help to improve the condition at home. Cold is usually indicated immediately after an injury, thermal procedures - during chronic inflammation; in any case, the use of any methods of exposure should be discussed with your doctor.

If bursitis is infectious, then the elbow bag should be completely drained, that is, all inflammatory fluid or pus should be removed. A prerequisite is to ensure rest of the elbow joint and prescribe antibacterial drugs. Patients with infectious bursitis are monitored by a doctor until the inflammation disappears completely.


Surgical treatment.  
Drainage of the elbow bag.
If an acute infection develops or microorganisms are sown as a result of studying the fluid obtained from the elbow bag, then drainage of the elbow bag is necessary. The elbow bag is opened surgically, that is, a small incision is made through which the discharge can be completely drained. Sometimes it is advisable to use a tube or half-tube to improve the outflow. After the outflow of secretions is ensured, the patient is observed until the wound is completely healed.

Usually, improvement occurs within a few days. With infectious bursitis, antibacterial drugs must be prescribed.
  
Removal of the Bursa (bursectomy).
With chronic bursitis, the walls of the bag thicken, the bag increases in size, and folds of the bag appear. With conservative treatment, it is possible to relieve inflammation, but after some time the inflammatory process worsens again. Doing work and everyday activities becomes difficult. In this case, you should think about surgical treatment - removal of the elbow bag.

An incision is made in the projection of the elbow bag. The bag is dissected. Determining the boundaries of the bag usually does not cause difficulties, since its walls are significantly thickened. After removing the bag itself, the ulnar process must be examined. Any unevenness on the ulnar process should be removed, and its surface should be smoothed out. After that, the skin is sewn up in layers. After the operation, it is advisable to place the hand in a splint for several days to ensure rest and better healing of the postoperative wound, after which rehabilitation measures can begin.