For prepatellar bursitis, which statement best describes management?

For prepatellar bursitis, which statement best describes management?

• A. Conservative management with ice, compression, padding, elevation, analgesics, and activity modification
• B. Corticosteroid injection is the standard first-line treatment
• C. Fluid aspiration should never be performed
• D. Surgical drainage is the initial management in most cases

Answer: (A)

Conservative management is the appropriate first-line approach for noninfectious prepatellar bursitis. This condition often stems from repetitive kneeling or minor trauma, causing swelling over the patella. The goal is to reduce inflammation and pain while minimizing irritation to the bursa. Rest and activity modification prevent further aggravation, while ice helps limit swelling and discomfort. Padding or a kneeling cushion protects the knee during use, compression supports the swelling, and elevation helps decrease edema. Analgesics, such as NSAIDs or acetaminophen, address pain without invasive procedures. Invasive options aren’t the initial step unless symptoms are severe or infection is suspected. Fluid aspiration may be needed if there’s a large effusion or diagnostic concern for infection, but it isn’t universally required. Corticosteroid injections carry infection and soft-tissue injury risks and aren’t standard first-line therapy, and surgical drainage is reserved for septic bursitis or persistent, refractory cases after conservative measures have failed.

Conservative management is the appropriate first-line approach for noninfectious prepatellar bursitis. This condition often stems from repetitive kneeling or minor trauma, causing swelling over the patella. The goal is to reduce inflammation and pain while minimizing irritation to the bursa. Rest and activity modification prevent further aggravation, while ice helps limit swelling and discomfort. Padding or a kneeling cushion protects the knee during use, compression supports the swelling, and elevation helps decrease edema. Analgesics, such as NSAIDs or acetaminophen, address pain without invasive procedures.

Invasive options aren’t the initial step unless symptoms are severe or infection is suspected. Fluid aspiration may be needed if there’s a large effusion or diagnostic concern for infection, but it isn’t universally required. Corticosteroid injections carry infection and soft-tissue injury risks and aren’t standard first-line therapy, and surgical drainage is reserved for septic bursitis or persistent, refractory cases after conservative measures have failed.