|
Year |
2003 |
|---|---|
|
Question Number |
58 |
|
Category |
Sports Medicine |
Question
A 13-year-old wrestler has had swelling and redness over the anterior knee after sustaining an abrasion 2 weeks ago. Examination reveals no knee effusion and active motion from 0 to 100 degrees. Radiographs show some soft-tissue swelling anterior to the patella. Management should consist of
1- Nonsteroidal anti-inflammatory drugs
2- Physical therapy
3- MRI
4- Corticosteroid injection
5- Aspiration
Figures
Answer (click for answer)
Answer: 5
Aspiration is the recommended treatment of prepatellar bursitis in wrestlers for 2 reasons:
1. Expedites resolution of bursitis
o If a "few" mLs are all that is present then the wrestler can return to action the next day.
o If > 20 mls are present then the knee should be wrapped, immobilized, reexamined and reaspirated daily as needed until the bursitis has resolved.
2. Rule out infection
o If infected then treatment consists of oral antibiotics and frequent aspirations to control infection
o If unresponsive then IV abx and bursotomy (lateral incision and insertion of hemostat to break up adhesions)
o If not successful, then bursectomy is indicated.
Reference: