The olecranon bursa lies in the posterior aspect of the elbow between the olecranon process of the ulna and the overlying skin. It usually exists as a single bursal sac or in some patients, as a multisegmented series of sacs that may be loculated in nature.
Four examples of unusual cases of olecranon bursitis:
1. Multiloculated: bursal sac has multiple segments
2. Combination of olecranon bursitis and deep elbow joint infection: This entity could be easily missed. Aspiration of the elbow joint away from the bursa is important in the diagnosis. Incision and drainage of the elbow joint and bursa is necessary.
3. Necrotizing fasciitis: it is severe infection spreading rapidly to the surrounding tissues. It may start benign. High index of suspicion and early diagnosis is necessary to save the limb or the life of the patient.
4. Combination of olecranon bursitis and other types of bursitis: inflammatory or metabolic causes may exist, that can be associated to bursitis. Both the elbow and knee may exhibit bursitis at the same time (as shown in the next picture).
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