II. Indications

III. Preparation

  1. Needle
    1. Gauge: 25-27 (injection), 18-20 (aspiration)
    2. Length: 1 to 1.5 inches
  2. Syringe: 5 ml (injection) or 20-30 ml (aspiration)
  3. Corticosteroid options
    1. Betamethasone (Celestone) 1 ml of 6 mg/ml
    2. Methylprednisolone (Depo-Medrol): 1 ml of 40 mg/ml
  4. Anesthetic
    1. Lidocaine 1%: 2 ml or
    2. Bupivacaine 0.25% or 0.5%: 2 ml

IV. Technique

  1. Patient position
    1. Patient supine with knee in slight flexion
    2. Prop up knee on towel roll in popliteal space
  2. Sterilize local skin with Betadine or Hibiclens
  3. Mark needle insertion site based on approach
    1. Palpate swelling over the Patella
      1. Bursa is anterior and inferior to Patella
    2. Mark point of maximal tenderness
  4. Insert needle into bursa and aspirate
    1. Inject Corticosteroid preparation

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