Aspiration and Injection of Olecranon Bursitis


OVERVIEW

 

INDICATIONS
  • Symptomatic or cosmetic concerns over distention of the olecranon bursa
  • Suspicion of septic bursitis of the olecranon bursa
CONTRAINDICATIONS
  • Uncooperative patient
  • Coagulopathy or bleeding diathesis
TECHNIQUE
  • Use a lateral approach to the elbow joint.
  • Place the elbow in 90-degree flexion, resting on a table, with the hand prone to widen the joint space.
  • Locate the radial head, lateral epicondyle of the distal humerus, and the lateral aspect of the olecranon tip. These three landmarks form the anconeus triangle.
  • The center of this triangle is the site for needle entry into the skin.
  • Using the tip of the gloved index finger of the nondominant hand, palpate a sulcus just proximal to the radial head.
  • The sulcus is the needle entry point.
  • Direct the needle medial and perpendicular to the radius toward the distal end of the antecubital fossa.






(1) Olecranon bursitis.
(2) Have the patient flex his or her elbow 90 degrees, and insert a 20- to 25-gauge, 1 -inch needle laterally to remove fluid.



(3)
Patients can receive NSAIDs, immobilization, and compression dressing after aspiration


(4) For acutely occurring bursitis that is infected, place an indwelling catheter in the bursa while intravenous, intramuscular, or oral antibiotics are administered