1Ultrasound of the Month – Case 27

Clinical History

• 64 year old female presented to outside emergency room with new onset of painful swelling of the left elbow.

• History of rheumatoid arthritis

• Physical exam demonstrated soft tissue swelling at the level of the olecranon bursa

• Aspiration of elbow in emergency room yielded scant bloody material- cultures negative for infection

• Pain and swelling continued and patient presented to her rheumatologist for further evaluation

2Ultrasound of the Month – Case 27

3Ultrasound of the Month – Case 27

4Ultrasound of the Month – Case 27

5Ultrasound of the Month – Case 27

Diagnosis: Infected Olecranon Bursitis

• Olecranon bursitis is an often painful inflammation of the olecranon bursa, an adventitial bursa at the posterior elbow

• Bursitis is most common in inflammatory conditions such as rheumatoid arthritis and gout and may also be associated with trauma

• Infection of the olecranon bursa is relatively rare but an increased risk is present in patients receiving medications resulting in immunosuppression

• Ultrasound is important in identifying and targeting any fluid collections for aspiration to definitively rule out infection

•