Part of my job as a San Diego elbow pain doctor requires constantly reviewing the latest literature on how and when to escalate cases of elbow pain into surgery. So I read this recent article with interest, as it describes a medical case presentation of the type we typically get on rounds as attending physicians:
A 42-year-old man with a history of metastatic lung cancer on chemotherapy and daily steroid therapy presented to the ED with right elbow pain. The pain had begun the day before, and the patient denied history of trauma, overuse, or increased time or pressure on his elbows. His review of systems was otherwise unrevealing.
In this case a deeper diagnostic look yielded a definitive cause: Septic Olecranon Bursitis, which is an infection of the fluid-filled sac that rests just behind the joint of the elbow. The “septic” part is the infection – brown liquid suggesting that bacteria had found their way into the fluid, causing swelling, pain and discomfort. This is not unexpected for a patient on chemotherapy, which can wallop the immune system and result in unusual sites of infection.
The article recommends antibiotics and drainage as first measures, but eventually discusses when elbow surgery may be a good idea:
Surgery or repeated drainage may be considered if the patient does not respond to conservative management. Surgical management as a first-line therapy is less likely to be successful and more likely to be associated with complications such as the creation of a chronic sinus tract when compared with aspiration.
For conservative elbow pain management and treatment, and the best elbow surgery in San Diego, contact AOSM for an appointment today.
