musculoskeletal and connective tissue disorders
How To Aspirate or Inject a Prepatellar Bursa
Indications for Aspirating or Injecting a Prepatellar Bursa
Aspiration of effusion to determine cause of bursitis Occasionally for injections of corticosteroid to treat recalcitrant or recurrent noninfectious inflammation Prepatellar bursal puncture is usually done diagnostically (eg, to diagnose septic or crystal-induced bursitis). Because the prepatellar bursa is the second most common site of septic bursitis, effusion fluid should routinely be sent to the laboratory for cell count and differential, crystal analysis, Gram stain, culture, and sensitivity tests. Corticosteroid injection is rarely necessary in the prepatellar bursa. Therapeutic injection should be done only if all of the following criteria are satisfied: Infection has been excluded by bursal fluid analysis. Bursal fluid repeatedly reaccumulates. Symptoms are not relieved by local measures such as ice, elevation, elastic bandage, and nonsteroidal and anti-inflammatory drugs. When needed, bursal injection may provide rapid relief, which is particularly beneficial for large or painful recurrent effusions. 