If a patient with prepatellar bursitis does not improve with initial treatment, what is the next best course of action?

In the case of prepatellar bursitis that does not improve with initial treatment, performing a bursal aspiration is a logical next step. Bursal aspiration allows for both diagnostic and therapeutic benefits. It can help relieve pain by reducing the volume of fluid in the bursa, which can alleviate pressure and inflammation. Additionally, the aspirated fluid can be analyzed to rule out infection or crystal-related arthropathies, providing valuable information for further management.

Bursal aspiration is typically considered before exploring other options, such as topical or oral analgesics, especially when there is no improvement with conservative treatment measures like rest, ice, or NSAIDs. The intervention is minimally invasive and can provide significant symptomatic relief, making it the preferred next step in management for resistant cases of bursitis.