What is Prepatellar Bursitis?
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What is Prepatellar Bursitis? |
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This Video Uploaded At 08-09-2021 11:31:01 |
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The prepatella bursa is a small fluid-filled sac which sits under the skin, on the front of the knee above the patella (kneecap). Occasionally it can become inflamed, a swollen and painful prepatellar bursa is bursitis, and known as Housemaid’s knee. Bursa are situated throughout the body (there are over 100 in total) and are located at anatomical ‘hotspots’, where two structures slide over each other in close proximity and there is a potential for unwanted friction.
The role of the bursa is two-fold.
They are responsible for:
Providing a frictionless surface for motion to occur. The prepatella bursa helps to provide smooth movement between the kneecap and the quadriceps tendon during knee extension (straightening of the knee).
Providing a protective barrier against direct impact or repetitive tasks. In the case of the prepatella bursa this is to protect the kneecap if you sustain a fall or kneel for a long period of time.
Under normal circumstances the prepatellar bursa perform their role successfully. However, on occasion they can become inflamed and painful. A painful, swollen prepatellar bursa is known as prepatellar bursitis (also known as Housemaid’s knee). This can occur because of:
Excessive pressure on the bursa from kneeling
Direct impact on the bursa from a fall
Infection
Secondary to a systematic inflammatory condition such as gout or rheumatoid arthritis
1. Septic bursitis
The is when the bursa gets infected and becomes painful and swollen. Due to its superficial location the pre patella bursa is susceptible to becoming infected. Luckily septic bursitis is relatively rare but it does require medical assistance. It has been reported to be responsible for hospital admissions rates of 1-12 cases per 10,000.
If the bursa looks red and hot (aswell as painful and swollen) you should see your GP as soon as possible as you will require immediate antibiotic treatment. You may also start to feel unwell and experience fever-like symptoms.
The pre patella bursa and the olecranon bursa of the elbow are the most common bursa to get infected. Research has shown the olecranon bursa (at the elbow) to be four times more susceptible to septic bursitis than the pre patella bursa (Baumbach et al., 2012).
2. Aseptic bursitis
This is when the bursa becomes swollen and painful but the bursa not infected, so it is not red aswell. This is, by far, the most common form of bursitis and is regularly associated with one or more of the below risk factors:
Sex – 80% of all bursitis patients have been reported to be male (Baumbach et al., 2012).
Age – bursitis can occur at any age however, the highest incidence rate of pre patella bursitis occurs between the fourth and sixth decade of life.
Repetitive pressure on the bursa during kneeling. This condition is known as housemaids’ knee and is associated with prolonged periods of weight bearing onto the kneecap. It is often seen in occupations such as carpet laying and building.
Direct impact/trauma to the tip of the kneecap, such as after falling directly onto your knee.
Rheumatological conditions such as gout or rheumatoid arthritis can cause the pre patella bursa to become inflamed (Sayegh et al., 2014).
The hallmark symptoms of prepatella bursitis are pain and swelling on the front of the knee. Symptoms can start rapidly after trauma or can gradually become apparent with repetitive tasks such as working in your knees.
How is prepatella bursitis diagnosed?
Obtaining an accurate diagnosis of pre patella bursitis is essential in providing you with the most appropriate treatment. A doctor or physiotherapist is able to diagnose pre patella bursitis.
Pre patella bursitis symptoms often include:
Pain located over the kneecap
Localised swelling on the front of the knee – in some cases, swelling can be significant resulting in a large soft pocket of fluid sitting over the kneecap
Pain with kneeling, sitting and walking
Stiffness and tightness with knee flexion (bending of the knee) due to swelling of the pre patella bursa
If the pre patella bursa is septic the following symptoms may also be present:
The skin over the kneecap may become red
Increased temperature – Between 63 and 100% of all patients with bursitis have a red and hot bursa (Del Buono et al 2012)
In some cases, you may feel unwell. Fever in the presence of bursitis can be the sign of an infected bursa (Oliveira et al., 2015)
If you experience any of these symptoms it is strongly advised that you make an appointment with your GP.
This video should not serve as a replacement for professional health or medical advice.
Always consult a health professional before starting a new exercise or fitness programme.
Please stop and consult a physiotherapist if these exercises cause you pain. |
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