Ortho 2 Exam 3 (Elbow) --> Olecranon Bursitis, OA, Nursemaid's Elbow (8/9)

what is olecranon bursitis

- inflammation of the bursal sac

what are the 3 types of olecranon bursitis

- 1: aseptic = trauma or sustained pressure

- 2: septic = nearby wound or cellulitis infection

- 3: chronic = repeated bursitis episodes; may be secondary to gout, DM

how does olecranon bursitis present clinically?

- painful

- possible recent trauma or related medical condition

- fever, redness, warmth, swelling

treatment for aseptic bursitis

- aspiration

- typically resolves quickly

treatment for septic bursitis

- aspiration and antibiotics

- may take up to 40 days to recover

treatment for chronic bursitis

- activity modification

- medication

- cortisone injection

- aspiration

- elbow padding to offset pressure on the olecranon

what is primary OA

degenerative

what is secondary OA

traumatic

radiographic findings of OA

- subchondral sclerosis

- osteophytes

- decreased joint space

age for primary OA vs secondary OA

- primary : 40-60 male

- secondary: under 40 male or female

history considerations for primary OA vs secondary OA

- primary: occupation requiring repetitive UE activity or WB

- secondary: trauma or surgery

onset considerations for primary OA vs secondary OA

- primary: insidious

- secondary: typically within several years of an injury

symptoms for OA (primary and secondary are the same) (4)

- loss of terminal extension

- painful locking

- pain at end range flexion and extension

- ulnar neuropathy

how are radiographs different for primary OA vs secondary OA

- primary: anterior/medial osteophytes with normal joint space

- secondary: joint space destruction

conservative management of OA

- education on activity modification

- STM and stretching to improve flexibility of soft tissue

- joint mobilization (UH distraction)

- proximal stability (shoulder strengthening)

- modalities

surgical management for OA (4)

- debridement

- osteophyte excision

- contracture release

- arthroplasty

What is nursemaids elbow?

- radial head subluxation/dislocation into the annular ligament

presentation of Nursemaids elbow

- pain

- elbow held in flexion and pronation

treatment for nursemaids elbow

- easily reduces with forearm supination