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Bursite do Olecrano

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Olecranon bursitis — causes, symptoms, and when to seek urgent medical attention for infection.

Updated Aug 2026
Uma ilustração desenhada à mão de uma pessoa sem rosto, com o cotovelo dobrado apoiado sobre uma mesa, apresentando um inchaço mole e volumoso na ponta do cotovelo.
Bursite do olecrano: o amortecedor preenchido por fluido (bursa) sobre a ponta óssea do cotovelo incha, produzindo o caroço característico em forma de 'ovo de ganso' visto aqui. Kieran Hirpara 4.0

Esta página foi traduzida automaticamente e ainda não foi verificada por um médico. A versão em inglês é a versão oficial.

O que você está sentindo

Provavelmente, você notará um inchaço visível na ponta do cotovelo. Esse inchaço provém da bursa, uma pequena bolsa preenchida por fluido que amorteciona o seu osso. Em muitos casos, esse inchaço é indolor. No entanto, você pode sentir sensibilidade ao pressioná-lo ou apoiar o cotovelo contra superfícies duras.

Se o inchaço for causado por uma infecção, você pode sentir uma dor mais significativa. A área pode ficar vermelha, quente ao toque e inchada. Você também pode desenvolver febre. Esses sinais sugerem que seu corpo está combatendo bactérias. Se você teve esse inchaço por um longo tempo sem melhora, pode ser devido a um tipo menos comum de bactéria. Isso pode acontecer mesmo que seu sistema imunológico seja saudável.

Você pode achar tarefas diárias difíceis. Alcançar as costas para fechar um sutiã ou guardar a camisa dentro da calça pode ser desconfortável. Dobrar completamente o braço também pode parecer restrito ou doloroso. Dormir do lado onde o inchaço está localizado pode pressionar a bursa e perturbar o seu descanso.

Em casos raros, você pode experimentar dor sem um grande inchaço visível. Isso pode ser devido a uma condição em que o tecido ósseo perde seu suprimento sanguíneo. Isso é incomum em adultos, mas pode causar desconforto significativo.

Se você teve inchaços recorrentes, é importante identificar a causa. Às vezes, a pele sobre o cotovelo pode se romper, criando uma úlcera que parece uma infecção. Isso requer uma avaliação cuidadosa para distingui-la da bursite padrão.

Entendemos que lidar com o inchaço do cotovelo pode ser frustrante. Nossa abordagem foca em entender seus sintomas específicos para orientar o tratamento adequado. Seja a causa um desgaste simples ou uma infecção persistente, nosso objetivo é aliviar sua dor e restaurar seu movimento.

O que está realmente acontecendo

O seu cotovelo possui uma pequena bolsa preenchida por fluido chamada bursa olecraniana. Ela está localizada exatamente sobre a ponta do osso do braço. Pense nela como um pequeno balão de água ou uma junta. Sua função é permitir que a sua pele deslize suavemente sobre o osso quando você dobra o braço.

Quando essa bolsa se irrita, ela se enche de excesso de fluido. Isso causa o inchaço que você vê e sente. Não se trata de artrite dentro da própria articulação. É um problema com a almofada localizada na parte externa. O acúmulo de fluido cria pressão. Essa pressão faz com que a área pareça tensa, quente ou sensível ao toque.

Às vezes, bactérias entram nesse espaço. Isso causa uma infecção conhecida como bursite séptica. O corpo reage produzindo mais fluido para combater os germes. Isso leva a vermelhidão e calor significativos. Em outros casos, não há infecção. Isso é chamado de bursite não séptica. Frequentemente, é causada pelo apoio repetido dos cotovelos ou por um impacto direto.

Em alguns casos crônicos, o tecido ao redor da bursa se altera. Você pode sentir um cordão firme sob a pele. Isso é tecido cicatricial se formando enquanto o corpo tenta curar a área. Esses cordões podem fazer com que o inchaço pareça mais duro e menos flexível.

Se o inchaço não desaparecer, ele pode se tornar recorrente. O fluido continua voltando. É por isso que analisamos diferentes maneiras de gerenciá-lo. Algumas pessoas encontram alívio com repouso e compressão. Outras precisam de tratamento mais ativo.

Oferecemos opções como drenar o fluido ou usar um escopó para limpar o tecido irritado. A desbridamento endoscópico é um procedimento simples e minimamente invasivo. Ele ajuda a remover o tecido inflamado que está causando o problema. Para alguns, essa abordagem oferece recuperação rápida e baixa dor.

É importante escolher o caminho certo para o seu caso específico. Infecções simples frequentemente se resolvem apenas com antibióticos. Você pode nem precisar de cirurgia. No entanto, se a bursa continuar se enchendo, podemos sugerir a remoção completa dela. Isso é chamado de bursectomia.

Entender o que está acontecendo ajuda você a tomar decisões informadas. Não se trata apenas de remover o fluido. Trata-se de corrigir a causa raiz da irritação. Isso garante conforto e função a longo prazo para o seu cotovelo.

O que podemos fazer a respeito

A abordagem adotada em nossa clínica reflete a forma como o Dr. Kieran Hirpara, cirurgião do membro superior no Mater Private Hospital Rockhampton, gerencia essa condição. Os pacientes chegam à nossa prática por meio de referência de um médico de família ou fisioterapeuta. Iniciamos com uma avaliação minuciosa, incluindo anamnese, exame físico e exames de imagem, se necessário, para confirmar o diagnóstico. Na maioria dos casos, iniciamos com o tratamento não operatório. Isso inclui alterar suas atividades diárias para evitar pressão no cotovelo, usar talas para suporte e realizar fisioterapia ou terapia da mão para restaurar o movimento. Também consideramos injeções para reduzir a inflamação. Geralmente, reservamos a cirurgia para quando essas medidas conservadoras não proporcionam melhora suficiente ou se você tem uma questão estrutural aguda que requer atenção imediata.

Se o inchaço for causado por infecção (bursite séptica), muitas vezes o gerenciamos empiricamente sem drenar o fluido primeiro. Evidências mostram que isso é eficaz, e nenhum paciente nos grupos estudados precisou de cirurgia. Se o inchaço não estiver infectado (bursite asséptica), podemos usar injeções. A literatura recente indica que injeções intrabursais e cirurgia podem ter mais efeitos adversos do que o manejo não invasivo para o tratamento inicial de casos não sépticos. No entanto, para casos recorrentes que não respondem aos cuidados básicos, podemos oferecer escleroterapia com doxiciclina ou ablação hidrotermal usando calor entre 50°C e 52°C. Essas opções minimamente invasivas são seguras e têm menos complicações do que a cirurgia aberta. Para a dor, podemos recomendar medicamentos anti-inflamatórios. A duração do alívio varia de acordo com o indivíduo e o tratamento específico utilizado, por isso discutimos o cronograma esperado com você durante sua consulta.

A cirurgia é considerada quando o tratamento conservador atingiu seu limite ou se a bursite continua voltando. Podemos realizar uma bursectomia endoscópica, que envolve a remoção da bursa inflamada por meio de pequenas incisões. Esse método oferece mínima invasividade, menos dor no pós-operatório e uma recuperação rápida. Em populações estudadas, esse procedimento resultou em nenhuma recorrência ou complicações de cicatrização da ferida que exigissem retorno à sala de operações. A taxa geral de revisão após bursectomia para bursite do olécrano é de 11,5%. Em alguns casos, podemos reparar a bursa com suturas em vez de removê-la, o que pode oferecer benefícios funcionais e estéticos. Também consideramos a cirurgia se houver um espolão de tração no osso ou se infecções incomuns, como a doença micobacteriana, forem identificadas. Revisamos todas as opções com você para garantir que o plano corresponda às suas necessidades e estilo de vida.

O que esperar

O seu prognóstico depende em grande parte do tipo de bursite que tem. Na maioria dos casos de bursite não séptica, o seu cirurgião pode recomendar inicialmente um tratamento não invasivo. Evidências recentes indicam que as injeções ou a cirurgia para o tratamento inicial podem, por vezes, causar mais efeitos adversos do que os cuidados conservadores. Se a sua condição for não complicada e séptica, o tratamento empírico sem aspiração é frequentemente eficaz. Nestes casos, nenhum dos pacientes necessitou de cirurgia adicional.

Se tiver bursite recorrente ou crónica, os sintomas podem persistir ou recidivar. Poderá necessitar de procedimentos adicionais se o tratamento conservador falhar. Por exemplo, num grupo de pacientes que teve aspiração tradicional, 8 em cada 11 necessitaram de bursectomia. A bursectomia é a remoção cirúrgica da bursa inflamada. A taxa de revisão após esta cirurgia é de 11,5%. Isto significa que cerca de um em cada nove pacientes pode necessitar de outro procedimento.

A recuperação sente-se de forma diferente consoante o caminho de tratamento. A bursectomia endoscópica oferece uma operação simples com mínima invasividade. Os pacientes relataram elevada satisfação e nenhuma recidiva ou complicações na cicatrização das feridas que exigissem o retorno à sala de operações. A ablação hidrotermal é outra opção segura para casos recorrentes. Utiliza calor entre 50°C e 52°C. Este método tem menos complicações do que a bursectomia aberta e eficácia comparável.

Alguns fatores influenciam a sua satisfação. Os pacientes com cordões do olécrano estavam menos satisfeitos após a excisão cirúrgica em comparação com aqueles sem cordões. Os cordões do olécrano são bandas de tecido cicatricial. Se tiver estes cordões, o seu cirurgião discutirá este risco consigo.

Em casos raros, a bursite pode ser causada por infeções incomuns, como micobactérias não tuberculosas ou prototheca. Estas condições têm frequentemente um curso prolongado. Se o seu inchaço não diminuir, o seu cirurgião considerará estas causas. Distinguir entre bursite séptica e asséptica pode ser difícil devido aos sintomas sobrepostos.

No geral, muitos pacientes têm um bom resultado com uma gestão cuidadosa. O seu cirurgião adaptará o plano à sua situação específica. Seja honesto sobre os seus sintomas para que possamos escolher o caminho mais seguro para si.

Quando procurar ajuda médica

Consulte o seu médico de família se tiver um cotovelo inchado que não melhora com repouso. Procure atendimento urgente se notar vermelhidão, calor ou febre, pois estes sinais podem indicar infeção. Pode ser difícil distinguir o inchaço infeccioso do não infeccioso. Solicite uma avaliação por um especialista se a dor persistir durante semanas. O inchaço recorrente requer exames para excluir causas incomuns. Não ignore a piora súbita, fraqueza ou bloqueio articular. Estes sintomas podem indicar problemas mais profundos, como alterações ósseas. Uma avaliação precoce ajuda a evitar complicações decorrentes de tratamentos invasivos. O seu cirurgião irá orientá-lo para a opção mais segura e menos invasiva em primeiro lugar.

Reviewed by Dr Kieran Hirpara · 7 August 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Nonsurgical management of olecranon bursitis is significantly more effective and safer than surgical management [1].
  • Empirical management of uncomplicated septic olecranon bursitis without aspiration is effective, with no patients requiring bursectomy [7].
  • Deferring aspiration in uncomplicated septic olecranon bursitis is a reasonable treatment option [12].
  • In a comparison of empirical management versus traditional aspiration for uncomplicated septic olecranon bursitis, 8 of 11 patients in the traditional aspiration group required bursectomy [7].
  • Nontuberculous mycobacterial olecranon bursitis should be considered in any patient with a swollen bursa and protracted course, regardless of immune status [5].
  • Intrabursal doxycycline sclerotherapy may be an effective alternative to surgical bursectomy for patients with recurrent olecranon bursitis refractory to conservative management [6].
  • Hydrothermal ablation at temperatures between 50°C and 52°C is a safe treatment option for recurrent or chronic olecranon bursitis with fewer complications than open bursectomy and comparable efficacy [14].
  • Endoscopic olecranon bursectomy for recalcitrant olecranon bursitis resulted in no recurrences or wound-healing complications necessitating return to the operating room [2].
  • The revision rate after bursectomy for olecranon bursitis is 11.5% [10].
  • Bursal suture repair is a viable alternative to bursectomy in selected patients with chronic traumatic olecranon bursitis, combining functional and cosmetic benefits [3].
  • Olecranon extrabursal endoscopic bursectomy provides a satisfactory view with less morbidity than the open method while avoiding a wound over the sensitive point of the olecranon [4].
  • Endoscopic debridement combined with compression suture for recalcitrant aseptic olecranon bursitis offers simple operation, minimal invasiveness, minimal postoperative pain, rapid recovery, a low recurrence rate, and satisfactory overall efficacy [17].
  • Patients with olecranon cords were less satisfied after surgical excision compared to those without cords [16].

Anatomy & Pathophysiology

  • Olecranon bursae can contain cords [16].
  • MR imaging is probably the method of choice for determining the development of olecranon bursae and their fluid content [19].
  • Distinguishing between septic and aseptic olecranon bursitis can be difficult because physical and laboratory data overlap [11].
  • Traumatic lesions of the olecranon bursa are common injuries associated with a high risk of complications [8].
  • Providers should maintain a high index of suspicion for full-thickness triceps tears in patients with specific risk factors and comprehensive musculoskeletal examination to ensure accurate diagnosis, as these tears can be misdiagnosed as olecranon bursitis [23].

Classification

  • Extrabursal endoscopic bursectomy provides a satisfactory view with less morbidity than the open method while avoiding a wound over the sensitive point of the olecranon [4].
  • Empirical management of uncomplicated septic olecranon bursitis without aspiration was effective, with no patients requiring bursectomy, whereas 8 of 11 patients in the traditional aspiration group required bursectomy [7].
  • Prospective studies are needed to guide optimal treatment for olecranon bursitis [9].
  • The revision rate after bursectomy for olecranon bursitis was 11.5% [10].
  • Distinguishing between septic and aseptic olecranon bursitis can be difficult because the physical and laboratory data overlap [11].
  • The first treatment line for olecranon bursitis is conservative, including ice, rest, anti-inflammatory and analgesic drugs and, occasionally, bursal fluid aspiration [15].
  • Pyoderma gangrenosum must be considered in the differential diagnosis whenever a patient presents with ulcerative cutaneous lesions that resemble an infectious process such as olecranon bursitis [18].

Investigations

  • Protothecal olecranon bursitis is a distinct entity that may require excision for cure [13].
  • MR imaging is probably the method of choice for determining both the development of the bursae and their fluid content [19].

Treatment

Non-Operative Management

  • Empirical management of uncomplicated septic olecranon bursitis without aspiration was found to be effective with no patients requiring bursectomy [7].

Operative Management

  • Endoscopic olecranon bursectomy provides a satisfactory view with less morbidity than the open method while avoiding a wound over the sensitive point of the olecranon [4].
  • Endoscopic debridement combined with compression suture for recalcitrant aseptic olecranon bursitis offers advantages including simple operation, minimal invasiveness, minimal postoperative pain, rapid recovery, a low recurrence rate, and satisfactory overall efficacy [17].
  • Excision has been curative for all lesions of the olecranon bursa in cases of protothecal infection [13].

Special Considerations

  • More prospective studies are needed to guide optimal treatment for olecranon bursitis [9].

Complications

  • Empirical management of uncomplicated septic olecranon bursitis was effective with no patients requiring bursectomy, whereas 8 of 11 patients in the traditional aspiration group required bursectomy [7].
  • Traumatic lesions of the olecranon bursa or prepatellar bursa are common injuries associated with a high risk of complications [8].
  • Excision has been curative for all lesions of the olecranon bursa, whereas multiple medications have been tried for cutaneous and systemic infections without clear-cut success [13].
  • Hydrothermal ablation at temperatures between 50C and 52C is a safe treatment option for recurrent or chronic olecranon bursitis with fewer complications than open bursectomy and a comparable efficacy [14].

Recovery

  • Empirical management of uncomplicated septic olecranon bursitis without aspiration is effective, with no patients in the empirical group requiring bursectomy [7].
  • Eight of 11 patients in the traditional aspiration group for uncomplicated septic olecranon bursitis required bursectomy [7].
  • Patients who underwent endoscopic olecranon bursectomy for recalcitrant olecranon bursitis experienced no recurrences or wound-healing complications necessitating return to the operating room [2].
  • Excision has been curative for all lesions of the olecranon bursa in cases of protothecal infection, whereas multiple medications have been tried for cutaneous and systemic infections without clear-cut success [13].

Key Evidence

  • [L4] Based primarily on level IV evidence, nonsurgical management of olecranon bursitis is significantly more effective and safer than surgical management. [1] (10.1007/s00402-014-2088-3)
  • [L4] In this population, patients who underwent endoscopic olecranon bursectomy experienced no recurrences or wound-healing complications necessitating return to the operating room. [2] (10.1016/j.asmr.2023.100832)
  • [L5] Bursal suture repair is a viable alternative to bursectomy in selected patients with chronic traumatic olecranon bursitis, combining functional and cosmetic benefits. [3] (10.1016/j.xrrt.2025.100597)
  • [L4] This approach provides a satisfactory view with less morbidity than the open method while avoiding a wound over the sensitive point of the olecranon. [4] (10.1097/bth.0b013e31829c0535)
  • [L4] Nontuberculous mycobacterial olecranon bursitis should be considered in any patient with a swollen bursa and protracted course, regardless of immune status. [5] (10.1016/j.jse.2008.07.009)
  • [L4] This may be an effective alternative to surgical bursectomy for patients with recurrent olecranon bursitis refractory to conservative management. [6] (10.1016/j.jhsg.2024.03.006)
  • [L4] Empirical management of uncomplicated septic olecranon bursitis was found to be effective with no patients requiring bursectomy, whereas 8 of 11 patients in the traditional aspiration group required bursectomy. [7] (10.1016/j.jhsa.2019.06.012)
  • [Paper] Traumatic lesions of the olecranon bursa or prepatellar bursa are common injuries associated with a high risk of complications. [8] (10.1007/s00402-017-2690-2)
  • [L5] More prospective studies are needed to guide optimal treatment. [9] (10.1016/j.jhsa.2021.02.006)
  • [L3] The revision rate after bursectomy for olecranon bursitis was 11.5%. [10] (10.1016/j.jse.2020.09.033)
  • [L5] Distinguishing between septic and aseptic olecranon bursitis can be difficult because the physical and laboratory data overlap. [11] (10.1016/j.jse.2015.08.032)
  • [L4] Deferring aspiration in uncomplicated septic olecranon bursitis is a reasonable treatment option. [12] (10.1016/j.jhsa.2018.06.059)
  • [Case_report] Excision has been curative for all lesions of the olecranon bursa, whereas multiple medications have been tried for cutaneous and systemic infections without clear-cut success. [13] (10.2106/00004623-198062050-00024)
  • [L4] Hydrothermal ablation at temperatures between 50C and 52C is a safe treatment option for recurrent or chronic olecranon bursitis with fewer complications than open bursectomy and a comparable efficacy. [14] (10.1016/j.jse.2024.03.021)
  • [L4] The first treatment line for olecranon bursitis is conservative, including ice, rest, anti-inflammatory and analgesic drugs and, occasionally, bursal fluid aspiration. [15] (10.1016/j.surge.2012.02.002)
  • [L4] Patients with olecranon cords were less satisfied after surgical excision compared to those without cords. [16] (10.1016/j.jse.2015.04.016)
  • [L4] Endoscopic debridement combined with compression suture for the treatment of aseptic olecranon bursitis has several advantages: simple operation, minimal invasiveness, minimal postoperative pain, rapid recovery, a low recurrence rate, and satisfactory overall efficacy. [17] (10.1186/s13018-024-05090-3)
  • [Case_report] PG must be considered in the differential diagnosis whenever a patient presents with ulcerative cutaneous lesions that resemble an infectious process such as olecranon bursitis. [18] (10.1016/j.jse.2014.06.032)
  • [L4] MR imaging is probably the method of choice for determining both the development of the bursae and their fluid content. [19] (10.1007/s002560050117)
  • [Case_report] Providers should maintain a high index of suspicion for triceps tears in patients with specific risk factors and comprehensive musculoskeletal examination to ensure accurate and timely diagnosis. [23] (10.1016/j.xrrt.2024.02.002)

References

[1] Treatment of olecranon bursitis: a systematic review. Archives of Orthopaedic and Trauma Surgery. 2014. DOI: 10.1007/s00402-014-2088-3

[2] No Wound Healing Complications or Recurrences Were Seen and a High Level of Satisfaction Was Reported in Patients Who Underwent Endoscopic Olecranon Bursectomy for Recalcitrant Olecranon Bursitis. Arthroscopy, Sports Medicine, and Rehabilitation. 2024. DOI: 10.1016/j.asmr.2023.100832

[3] Olecranon bursal repair for chronic traumatic bursitis: a surgical technique. JSES Reviews, Reports, and Techniques. 2026. DOI: 10.1016/j.xrrt.2025.100597

[4] Olecranon Extrabursal Endoscopic Bursectomy. Techniques in Hand & Upper Extremity Surgery. 2013. DOI: 10.1097/bth.0b013e31829c0535

[5] Nontuberculous mycobacterial olecranon bursitis: Case reports and literature review. Journal of Shoulder and Elbow Surgery. 2009. DOI: 10.1016/j.jse.2008.07.009

[6] Intrabursal Doxycycline Sclerotherapy for Recurrent Olecranon Bursitis of the Elbow: A Case Control Study. Journal of Hand Surgery Global Online. 2024. DOI: 10.1016/j.jhsg.2024.03.006

[7] Empirical Treatment of Uncomplicated Septic Olecranon Bursitis Without Aspiration. The Journal of Hand Surgery. 2020. DOI: 10.1016/j.jhsa.2019.06.012

[8] Treatment and outcome with traumatic lesions of the olecranon and prepatellar bursa: a literature review apropos a retrospective analysis including 552 cases. Archives of Orthopaedic and Trauma Surgery. 2017. DOI: 10.1007/s00402-017-2690-2

[9] Clinical Management of Olecranon Bursitis: A Review. The Journal of Hand Surgery. 2021. DOI: 10.1016/j.jhsa.2021.02.006

[10] Factors associated with revision surgery for olecranon bursitis after bursectomy. Journal of Shoulder and Elbow Surgery. 2021. DOI: 10.1016/j.jse.2020.09.033

[11] Olecranon bursitis. Journal of Shoulder and Elbow Surgery. 2016. DOI: 10.1016/j.jse.2015.08.032

[12] Empiric Treatment of Uncomplicated Septic Olecranon Bursitis Without Aspiration. The Journal of Hand Surgery. 2018. DOI: 10.1016/j.jhsa.2018.06.059

[13] Protothecal olecranon bursitis. A case report and review of the literature.. The Journal of Bone & Joint Surgery. 1980. DOI: 10.2106/00004623-198062050-00024

[14] Hydrothermal ablation in recurrent or chronic olecranon bursitis: a prospective study. Journal of Shoulder and Elbow Surgery. 2024. DOI: 10.1016/j.jse.2024.03.021

[15] Diagnosis and management of olecranon bursitis. The Surgeon. 2012. DOI: 10.1016/j.surge.2012.02.002

[16] The existence of cords in olecranon bursae. Journal of Shoulder and Elbow Surgery. 2015. DOI: 10.1016/j.jse.2015.04.016

[17] Clinical efficacy of endoscopic debridement combined with compression suture in the treatment of recalcitrant aseptic olecranon bursitis. Journal of Orthopaedic Surgery and Research. 2024. DOI: 10.1186/s13018-024-05090-3

[18] Case report: misdiagnosed olecranon bursitis: pyoderma gangrenosum. Journal of Shoulder and Elbow Surgery. 2014. DOI: 10.1016/j.jse.2014.06.032

[19] The US,CT and MR findings of cubital bursitis: a report of five cases. Skeletal Radiology. 1996. DOI: 10.1007/s002560050117

[23] Full-thickness triceps tears misdiagnosed as olecranon bursitis: a case report. JSES Reviews, Reports, and Techniques. 2024. DOI: 10.1016/j.xrrt.2024.02.002

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Section 1 -- Definitions.

a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.