Background Olecranon bursitis is a well-described condition in adults but remains undercharacterized in the pediatric population. The primary aim of this study was to describe the presentation, diagnostic workup, management strategies, and outcomes of pediatric olecranon bursitis through a large single-center case series. Methods A retrospective review was conducted of patients under 18 years diagnosed with olecranon bursitis at a tertiary pediatric hospital from 2011 to 2024. Designation of septic bursitis required at least one of the following: (1) positive bursal or wound culture, (2) purulent drainage at procedure, or (3) elevated inflammatory markers (WBC, CRP, ESR) in the context of clinician suspicion for infection. Cases that did not meet any of these criteria were classified as aseptic/non-infectious. Iatrogenic cases related to orthopedic implants were excluded. Patient records were analyzed for demographics, etiology, clinical features, imaging findings, treatment modalities, microbiologic results, and outcomes. Results Sixty cases were identified in 58 patients, with a mean age of 13.5 years; 73% were male. Etiologies included trauma (47%), idiopathic (37%), and sports-related injuries (12%). Common presenting symptoms were swelling (95%), pain (77%), and tenderness (75%); fever was present in 20%. Imaging confirmed bursitis in 94% of ultrasound cases and 77% of MRI studies. Most cases (85%) were managed nonoperatively. Antibiotics were prescribed in 37% of cases, most commonly clindamycin, with a mean duration of 17.8 days. Hospitalization occurred in 30% of cases, with 82% of those initially treated with intravenous antibiotics. Surgical management was required in 15% of patients and included incision and drainage, aspiration, or arthroscopy. MRSA and MSSA were the most commonly identified pathogens. All surgically treated cases resolved without recurrence. Among nonoperative cases, recurrence occurred in 6%. Complications included cellulitis (15%), bacteremia (8%), and osteomyelitis (3%). Conclusions Pediatric olecranon bursitis most commonly follows trauma and is typically managed successfully with conservative treatment. Antibiotic use is frequent, and surgical intervention is reserved for refractory or septic cases, with excellent outcomes. Level of Evidence Level IV.

Clinical Features and Outcomes of Pediatric Olecranon Bursitis

期刊论文
发表日期：

2026年8月2日

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Srikhar Chilukuri,
Krishna Chandra,
Ali Asma,
Rebecca Schultz,
Indranil Kushare

摘要

Background

Olecranon bursitis is a well-described condition in adults but remains undercharacterized in the pediatric population. The primary aim of this study was to describe the presentation, diagnostic workup, management strategies, and outcomes of pediatric olecranon bursitis through a large single-center case series.

Methods

A retrospective review was conducted of patients under 18 years diagnosed with olecranon bursitis at a tertiary pediatric hospital from 2011 to 2024. Designation of septic bursitis required at least one of the following: (1) positive bursal or wound culture, (2) purulent drainage at procedure, or (3) elevated inflammatory markers (WBC, CRP, ESR) in the context of clinician suspicion for infection. Cases that did not meet any of these criteria were classified as aseptic/non-infectious. Iatrogenic cases related to orthopedic implants were excluded. Patient records were analyzed for demographics, etiology, clinical features, imaging findings, treatment modalities, microbiologic results, and outcomes.

Results

Sixty cases were identified in 58 patients, with a mean age of 13.5 years; 73% were male. Etiologies included trauma (47%), idiopathic (37%), and sports-related injuries (12%). Common presenting symptoms were swelling (95%), pain (77%), and tenderness (75%); fever was present in 20%. Imaging confirmed bursitis in 94% of ultrasound cases and 77% of MRI studies. Most cases (85%) were managed nonoperatively. Antibiotics were prescribed in 37% of cases, most commonly clindamycin, with a mean duration of 17.8 days. Hospitalization occurred in 30% of cases, with 82% of those initially treated with intravenous antibiotics. Surgical management was required in 15% of patients and included incision and drainage, aspiration, or arthroscopy. MRSA and MSSA were the most commonly identified pathogens. All surgically treated cases resolved without recurrence. Among nonoperative cases, recurrence occurred in 6%. Complications included cellulitis (15%), bacteremia (8%), and osteomyelitis (3%).

Conclusions

Pediatric olecranon bursitis most commonly follows trauma and is typically managed successfully with conservative treatment. Antibiotic use is frequent, and surgical intervention is reserved for refractory or septic cases, with excellent outcomes.

Level of Evidence

Level IV.