Prepatellar bursitis (also called maid’s knee, carpet knee, miner’s knee or carpenter’s knee) is inflammation of the bursa (fluid-filled sac) located in front of the patella (kneecap). Prepatellar bursitis occurs when your bursa is frequently irritated, damaged, or infected and produces too much fluid. The excess fluid causes your bursa to swell and puts pressure on other parts of your knee. You can usually see prepatellar bursitis because the front of the knee will look swollen. However, knee bursitis treatment depends upon the severity of the symptoms.
What is a bursa?
An adult has more than 150 bursae (plural for “bursa”) in the body. A bursa is a small, fluid-filled sac that cushions the area where your bone would otherwise rub against your muscles, tendons, or skin. By cushioning these areas, bursae help prevent friction and inflammation.
When your bursa sac is repeatedly irritated, damaged, or infected, its thin lining thickens and creates extra fluid. Excess fluid collects in your bursa sac and causes it to swell. This is called bursitis. Bursitis most often occurs in the bursae around the joints. Prepatellar bursitis is the second most common type of bursitis.
What tests are used to diagnose prepatellar bursitis?
Specific tests that may be used to diagnose prepatellar bursitis or rule out other possible conditions include:
- X-ray: Your health care provider may have you get an X-ray of your knee to make sure you don’t have an injury to the bone that’s causing your pain and swelling.
- CT scan or MRI: Your healthcare provider may have you undergo a CT scan or MRI to check for soft tissue injuries in or around the knee that could be causing swelling.
- Prepatellar bursa aspiration: If your healthcare provider thinks you may have a bursal infection, he or she may take fluid from your bursa with a fine needle (aspiration) to check the fluid for infection.
What are the signs and symptoms of prepatellar bursitis?
The symptoms of prepatellar bursitis depend on what type and how severe the bursitis is. There are three general symptoms of prepatellar bursitis, but you don’t have to have all three symptoms to have prepatellar bursitis. The three characters include:
- Swelling in the front of the knee: Almost all cases of prepatellar bursitis involve swelling in the front of the knee. You will be able to “see” and feel your swollen bursa through your skin. It usually feels “squished” when you press on it. If your prepatellar bursitis is not treated, the swelling may increase. However, treatment of medial knee pain depends upon the cause.
- Limits on range of motion in the knee: Mild to moderate cases of prepatellar bursitis usually do not limit your ability to bend and extend the knee. If you have a severe case of prepatellar bursitis, you may not be able to move your knee as you normally would.
- Pain: Some people do not experience pain with prepatellar bursitis. Others may feel pain or tenderness in the affected knee even when resting. Sometimes people with prepatellar bursitis don’t feel any pain when they rest, but feel pain or tenderness in the affected knee when they kneel or bend it.
If you have prepatellar bursitis caused by an infection, you are likely to have other symptoms, including:
- Having reddened or pinkish skin where your knee is swollen.
- knee hurts when straightened
- Having warmer skin where your knee is swollen.
- With a fever.
- Experiencing pain and chills.
If you experience these symptoms of infection, it is important to contact your healthcare provider or go to the nearest hospital immediately. Infected prepatellar bursitis requires medical treatment. If left untreated, it can cause serious and life-threatening complications.
Are there different kinds of prepatellar bursitis?
There are two types of the condition: Acute prepatellar bursitis and chronic prepatellar bursitis. Acute prepatellar bursitis occurs when there is sudden damage to your bursa in front of your patella. This usually occurs as a result of trauma (such as a hard blow to the knee) or infection. Chronic bursitis usually occurs as a result of repetitive overuse or pressure on the knee, such as frequent kneeling.
What causes prepatellar bursitis?
There are several situations and conditions that can cause prepatellar bursitis, including:
- Frequent kneeling: Most cases of prepatellar bursitis are caused by pressure and irritation from frequent kneeling.
- Direct trauma to the knee: Trauma to the knee from falling or being hit by something can cause prepatellar bursitis.
- Bacterial infection: If you have a scratch, bug bite, or cut on your knee that becomes infected, it can spread to your prepatellar bursa sac. This type of prepatellar bursitis is called infectious bursitis. It’s not that common, but it’s a serious condition that requires immediate medical attention.
- With rheumatoid arthritis and/or gout: Although less common, both rheumatoid arthritis and gout can cause prepatellar bursitis.
Common knee bursitis Treatment
Bursitis often gets better over time, so treatment is usually aimed at relieving symptoms. Depending on the cause of knee bursitis and which bursa is infected, your doctor may recommend one or more knee bursitis treatment approaches.
If an infection has caused the knee bursitis, your doctor will prescribe a course of antibiotic treatment.
Your doctor may refer you to a physical therapist or sports medicine specialist who can help you improve flexibility and strengthen your muscles. This therapy can relieve pain and reduce the risk of recurrent episodes of knee bursitis. Protective knee braces can help if you can’t avoid kneeling, and compression knee sleeves can help reduce swelling.
Surgical and other procedures
More-invasive treatments for knee bursitis treatment include:
- Corticosteroid injection. If bursitis is persistent and unresponsive to basic treatment, your doctor may apply a corticosteroid to the affected bursa to reduce inflammation. The inflammation usually goes away quickly, but you may have pain and swelling from the injection for a few days.
- Your doctor may aspirate the bursa to reduce excess fluid and treat inflammation. He inserts the needle into the affected bursa and draws fluid into the syringe. Aspiration may cause short-term pain and swelling, and you may need to wear a knee immobilizer for a short time after the injection to reduce the chance of re-swelling.
- If you have severe chronic or recurrent bursitis and are not responding to other treatments, your doctor may recommend surgery to remove the bursa.
Lifestyle and home remedies
To ease pain and discomfort of knee bursitis:
- Rest your knee. Stop the activity that caused your knee bursitis and avoid movements that make your pain worse.
- Take over-the-counter pain relievers. Short-term use of anti-inflammatory medications such as aspirin, ibuprofen (Advil, Motrin IB, others), or naproxen sodium (Aleve, others) can help relieve pain.
- Apply ice. Apply an ice pack to your knee for 20 minutes at a time several times a day until the pain subsides and the knee is no longer warm to the touch.
- Use compression. Using a compression wrap or knee sleeve can help reduce swelling.
- Raise your knee. Rest the affected leg on pillows to help reduce knee swelling.
Here are the Risk factors;
Knee bursitis is a common complaint, but the risk of developing this painful disorder can be increased from:
- Long kneeling. People who work on their knees for long periods of time – carpet layers, plumbers and gardeners – are at increased risk of knee bursitis.
- Participation in certain sports. Sports that result in direct impacts of frequent falls on the knee—such as wrestling, soccer, and volleyball—may increase the risk of knee bursitis. Runners can develop pain and inflammation in the pes anserine bursa, which is located on the inside of the knee below the joint.
- Obesity and osteoarthritis. Pes anserine bursitis, affecting the inside of your knee below the joint, often occurs in obese women with osteoarthritis.
To avoid knee bursitis or prevent it from recurring:
- Use knee pads. If you exercise on your knees or participate in sports that put your knees at risk, use knee pads to cushion and protect your knees.
- Take breaks. If you are on your knees for a while, take regular breaks to stretch your legs and rest your knees.
- Avoid excessive squatting. Excessive or repeated bending of the knees increases the force on the knee joints.
- Reach and maintain a healthy weight. This can help reduce pressure on the knee joint.
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