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Septic arthritis is the purulent invasion of a joint by an infectious agent [5] [6] with a resultant large effusion due to inflammation. [7] Septic arthritis is a serious condition. It can lead to irreversible joint damage in the event of delayed diagnosis or mismanagement. It is basically a disease of children and adolescence. [6]
The posterior fat pad is normally pressed in the olecranon fossa by the triceps tendon, and hence invisible on lateral radiograph of the elbow. [3] When there is a fracture of the distal humerus, or other pathology involving the elbow joint, inflammation develops around the synovial membrane forcing the fat pad out of its normal physiologic resting place.
Chronic, progressive pain and swelling of the affected joint are exacerbated by physical activity. Joint effusion and limited range of motion are common associated features. It affects primarily large joints, including knee (>50% of cases), elbow, hip, and shoulder. SOC is twice as common in men as women.
Pain, swelling, and deformity near the elbow or arm area is common and a bleed near the fracture may result in an effusion in the elbow joint. With severe displacement, there may be an anterior dimple from the proximal bone end trapped within the biceps muscle. The skin is usually intact.
The elbow is the region between the upper arm and the forearm that surrounds the elbow joint. [1] The elbow includes prominent landmarks such as the olecranon , the cubital fossa (also called the chelidon, or the elbow pit), and the lateral and the medial epicondyles of the humerus .
Patients with a fever, suspected flare of existing arthritis, or unknown cause of joint effusion should undergo arthrocentesis with synovial fluid analysis. Samples of synovial fluid can be analyzed for gross appearance, presence of crystals, white blood cell count with differential, red blood cell count, and bacterial culture.
A rheumatologist will aim to diagnose the cause of the patient’s pain by first determining whether it is inside the joint itself, meaning true synovitis, or if it is actually caused by an inflammation of the tendons, referred to as tendonitis. Imaging, such as an MRI or musculoskeletal ultrasound is often required to make a firm diagnosis.
Olecranon bursitis is a condition characterized by swelling, redness, and pain at the tip of the elbow. [1] [2] If the underlying cause is due to an infection, fever may be present. [2]