Best Practice Case Studies-Case 123 Asset 2 Ultrasound Evaluation of the Posterior Elbow

Case 123 Asset 2 Ultrasound Evaluation of the Posterior Elbow - Olecranon Bursitis

Video Transcription

Video Summary

The presentation focused on a case of posterior elbow pain and swelling initially diagnosed as septic olecranon bursitis in a man with prior elbow hardware. After treatment with IV antibiotics and clindamycin, he returned with improved swelling but persistent posterior elbow pain. Dr. Wilcox used the case to review a complete posterior elbow ultrasound protocol.<br /><br />Key ultrasound targets included the olecranon bursa, distal triceps tendon, posterior joint recess, distal humerus, and nearby nerves, with Doppler and dynamic scanning used when needed. Important technique tips were emphasized: keep the elbow relaxed in partial extension, use plenty of gel with minimal probe pressure, and consider dynamic flexion/extension to detect subtle joint fluid or snapping structures.<br /><br />Ultrasound showed small residual bursal fluid, distal triceps tendinopathy with a partial tear and calcification, mild neovascularization on Doppler, and mild post-traumatic arthritic changes. No significant posterior joint effusion or nerve entrapment was seen. The discussion also highlighted how ultrasound helps distinguish simple from complex bursitis, evaluate gout or inflammatory disease, and guide aspiration decisions even in patients with metal hardware.

Meta Tag

Edition 4th Edition

Related Case 4th Edition, Case 123

Topic Elbow

Keywords

4th Edition

4th Edition, Case 123

Elbow

posterior elbow pain

olecranon bursitis

ultrasound protocol

distal triceps tendon

Doppler imaging

partial tendon tear

joint effusion