referral criteria from primary care - prepatellar bursititis

Last edited 05/2019

Admission or referral

Criteria for admission to hospital

  • if septic bursitis, and:
    • extensive cellulitis, or
    • severe infection or
    • systemic toxicity, including high fever, or
    • development of an abscess - requires incision and drainage

  • if there is clinical suspicion of infection of the underlying knee join (septic knee joint)
    • if there is a limitation in range of movement of knee join - unlike in septic bursitis

  • if patient is immunocompromised or has other medical conditions, such as rheumatoid arthritis or diabetes (1)

Possible hospital admission or need for specialist advice

  • if the person has no response, or an inadequate response, to an antibiotic in septic bursitis
    • refer urgently or seek specialist advice
      • a change in antibiotic, intravenous antibiotic, or incision and drainage may be required

  • refer for expert assessment if:
    • recurrent septic bursitis - may be need for surgical excision of bursa after resolution of infection
    • a chronic discharging sinus - surgical excision may be indicated
    • non septic chronic bursitis
      • which does not respond to primary care management, or with significant recurrent swelling and/or pain

Reference:

Related pages:

prepatellar bursitis