Q. Last week I developed a sharp pain in my elbow while playing basketball. I am not sure if I banged it into the man I was defending but it hurt a lot. Over the next day it swelled a lot and I have had difficulty straightening it out and bending it all the way. I have taken some Advil and so far the pain and swelling have only gone down a little bit. I have never had elbow problems before. What do you think is going on and whom should I see?
A. Elbow swelling without a definite history of trauma is somewhat unusual. It is possible that you banged it, and if the swelling is on the back part of the elbow, this may be a form of “olecranon bursitis.” If the whole elbow joint is swollen, it is possible that there may be a loose bone fragment floating around irritating the elbow joint.
Since you are young and active, it is less likely that this would be a condition such as rheumatoid arthritis, gout, or pseudo-gout. I recommend you see an orthopedic surgeon or upper extremity specialist as soon as possible. In addition to the physical examination, the doctor will likely order X-rays to make certain there are no bony abnormalities or obvious loose bodies floating around.
If the examination reveals possible damage to a ligament or a tendon, the doctor may order an MRI as well. The reason I recommend prompt treatment is that you are having difficulty regaining your motion and if motion loss becomes chronic it is very difficult to regain full motion at a later time.
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Depending upon the diagnosis would determine what are the best treatment options. Bursitis may require drainage or oral anti-inflammatory medication and physical therapy. Ligament injury may require a period of rest, bracing, and rehabilitation or possible surgical intervention. Loose bodies floating around the elbow may require arthroscopic surgery to correct the problem.
Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to HarlanS@baptisthealth.net