II. Indications: Refractory to Conservative Measures
- Acute Olecranon Bursitis
- Chronic Olecranon Bursitis
- Olecranon Bursa Infection (aspiration only)
III. Aspiration of bursa fluid (Posterolateral triangle)
- Avoid if possible
- Risk of infection
- Risk of fistula formation
- Technique
- Patient supine with elbow flexed
- Mark area of maximal fluctuance for skin entry
- Aspirate with 22 gauge 1 inch needle
- Drain fluid
- Apply pressure dressing after aspiration
IV. Corticosteroid Injection
- Indication: Refractory to conservative measures
- Acute or chronic bursa inflammation
- Contraindications to Corticosteroid Injection
- Technique
- Always exclude Olecranon Bursa Infection first
- Use technique as under aspiration listed above
- Needle: 25 gauge, inch with 5 cc syringe
- Injection solution
- Lidocaine 1% 2 cc
- Corticosteroid options
- Methylprednisolone (40 mg/ml): 1 ml or
- Celestone Soluspan (3 mg/ml): 1 ml