What are the available treatment options for bursitis present on the elbow?
Patient's Query
Hi doctor,
One month ago, I was shocked to discover a large, painless mass on my left elbow. I consulted with my doctor by email, who diagnosed it as bursitis and prescribed a 30-day course of Meloxicam, which will end tomorrow. Over the last month, the mass has become notably softer and slightly less tall (see attached sheet with photos); width is unchanged, and the general decrease in size is so slight that it is within the limits of error of my measurements. Other than well-managed bursitis and migraine headaches, please note that I am in excellent health. The current medications include Meloxicam, Allopurinol, and Doxycycline. How is this lump likely to progress, and what are my options? Put differently, how long (if ever) could I expect it to take before being reabsorbed by the body? Is extraction of fluid a viable option?
Hi,
I am glad you chose icliniq for your medical-related queries.
I have reviewed all the photographs and the long list of investigations (attachment removed to protect the patient’s identity). Very nicely compiled. Well, this is known as olecranon bursitis. The common reason for this is increased uric acid, for which you are already taking Allopurinol. Now, it's only been one month since you started taking the medication. I would suggest you continue for at least three months, as it is quite slow to regress. If you do not see improvement in three months, you may need to consider surgical removal.
Hope I have clarified your query.
Thank you.
Patient's Query
Hi doctor,
Thank you for the quick and clear answer.
Two follow-up questions, if I may:
- Prior to surgery, does it make sense to try aspiration? What are the chances of success?
- What is the name of the most likely surgery, and how likely is it to be successful?
Hi,
Welcome back to icliniq.com.
Thanks for your follow up questions.
- In my experience, there are high chances of recurrence after aspiration. I do aspiration only if the patient demands and if the diagnosis is unclear. If there is slightest doubt of infection, surgery is the best treatment.
- The most important point is that very few percentage of people require surgery in this case which means most of these swellings resolve with medicines. In a few cases which do not improve, surgery or aspiration is an option. Surgery is invasive but it has better results than aspiration. The name is simply known as excision.
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