Novel treatment of prepatellar bursitis

A 31-yr-old soldier presented with an 8-mo history of right prepatellar bursitis with 1-mo history of pain and loss of range of motion. His symptoms did not respond to activity modification, compression, nonsteroidal anti-inflammatory agents, or repeated aspirations with fenestration. After thorough discussion, the soldier and his provider reviewed the literature and found a single case report of intrabursal sclerotherapy in two patients with recalcitrant prepatellar bursitis. After informed consent, the patient wished to proceed with the scelerotherapy. Utilizing ultrasound guidance, the bursal sac was aspirated then injected with the scerlosing agent polidocanol. The patient had a much slower reaccumulation of swelling and at the two week follow-up the procedure was repeated. The patient has had no reaccumulation of the fluid as of 10 mo post-procedure and has resumed all his normal activities with no symptom limitation. This case demonstrates that sclerotherapy has utility in the management of recurrent non-septic prepatellar bursitis.