Olecranon bursitis The olecranon bursa is located immediately posterior to the olecranon bone. It functions to allow the bony olecranon to glide smoothly across the overlying tissues during elbow motion. Because it has limited vascularity and a superficial location, it is susceptible to trauma and infection (Pangia & Rizvi, 2023). Olecranon bursitis can occur secondary to trauma, such as a fall directly onto the elbow (which can cause bleeding and an inflammatory response within the bursa), underlying inflammatory conditions, or infection. Athletes who participate in sports such as football, basketball, or volleyball are more susceptible. Underlying inflammatory conditions associated with this condition include rheumatoid arthritis, psoriatic arthritis, and gout. Triceps tendinitis Triceps tendinitis is a relatively uncommon condition that occurs as a result of heavy lifting and repetitive use, such as weightlifting and throwing (Taylor & Hannafin, 2012). In sports, it is more common in professional weightlifters, throwing athletes, and soccer players due to repetitive elbow extension motion. Workers whose activities include hammering, digging, or other repetitive elbow extension activities are at risk for triceps tendinitis. It occurs most commonly at the tendon–osseous junction. Systemic factors that can predispose an individual to developing triceps tendinitis include endocrine disorders such as diabetes. Local factors that can influence the onset of this Triceps avulsion injuries/distal triceps rupture Triceps avulsions from the olecranon are the result of traumatic injuries. The mechanism of injury is typically a fall on an outstretched hand with violent eccentric loading of the triceps (Taylor & Hannafin, 2012). With avulsion injuries, swelling, tenderness, ecchymosis, and a palpable defect just proximal to the olecranon are common findings with physical examination. Strength testing will show weakness with elbow extension. Triceps tendon ruptures are rare and occur most commonly because of a sudden forceful elbow contraction in weightlifters or in older males with underlying systemic disease (hyperparathyroidism, rheumatoid arthritis, type I diabetes). The rupture most commonly occurs at the osseous insertion of the medial or lateral head and less frequently at the musculotendinous junction. Anabolic steroid use is a risk factor, as is chronic olecranon bursitis (Ahmed & Ahn, 2022). Although not common, impingement of the posterolateral plica in the radiocapitellar joint is a potential cause of posterolateral elbow pain. Synovial plica is an embryonic remnant. Clinical Presentation Clinical presentation may include snapping or catching in the elbow joint, pain at terminal elbow extension, and limited extension range of motion. Clinical examination should include palpation of the posterolateral radiocapitellar joint for tenderness (Park et al., 2019). A special test for this condition is the posterolateral radiocapitellar plica test. With the client seated and the arm in full elbow extension, the examiner places the thumb of one hand on the involved posterolateral aspect of the radiocapitellar joint. With the other hand, the examiner grasps the wrist and puts the forearm in a pronated position. The examiner applies manual force to the posterolateral aspect of the radiocapitellar joint to check for tenderness.
Clinical Presentation Clinical presentation includes swelling over the olecranon, which may restrict motion. If associated with an infection, there will be redness and tenderness (Pangia & Rizvi, 2023). Treatment typically involves NSAIDs, rest, compression, and ice. At times, needle aspiration of the infected bursa is indicated (Card & Lowe, 2023).
condition include corticosteroid injections, anabolic steroids, overtraining, and olecranon bursitis (Taylor & Hannafin, 2012). Clinical Presentation Clinical presentation typically includes posterior elbow pain and weakness with triceps extension. Tenderness to palpation over the triceps tendon is common, as is pain with forced extension against resistance. Swelling may be present (Laratta et al., 2017). Clinical Presentation Patients often feel a painful pop with injury onset. Examination may find swelling and ecchymosis over the posterior elbow. A palpable defect may be noted as well. Weakness with elbow extension against resistance will be present (although an intact lateral expansion of compensating anconeus muscle will make this weakness less notable; Ahmed & Ahn, 2022). A special test for diagnosing this condition is the modified Thompson squeeze test. With the patient lying prone and with the elbow at the edge of the table with the forearm hanging down, the examiner firmly squeezes the triceps muscle. If no elbow extension occurs, this suggests a complete disruption of the triceps (Ahmed & Ahn, 2022).
ELBOW IMPINGEMENT
The examiner then flexes the elbow while maintaining manual force. If the tenderness is markedly diminished at more than 90 degrees of flexion with maintenance of manual compression force, this test is considered positive (Park et al., 2019). Self-Assessment Quiz Question #6 There are several possible sources of posterior elbow pain. The diagnosis that is associated with posterolateral pain, snapping or catching in the elbow joint, pain at end range extension, and limited elbow extension range of motion is: a. Triceps bursitis. b. Triceps tendinitis.
c. Elbow impingement. d. Triceps avulsion injury.
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