Prepatellar bursitis

Last revised by Ashesh Ishwarlal Ranchod on 28 Mar 2023

Prepatellar bursitis is inflammation and fluid collection within the prepatellar bursa, located between the patella and the overlying subcutaneous tissue. It has been historically referred to as "housemaid's knee".

Main symptoms are anterior knee pain and swelling.

Chronic irritation due to trauma or repetitive kneeling leads to accumulation of fluid within the prepatellar bursa and sometimes hemorrhagic transformation. Less common causes include:

May show

  • prepatellar soft tissue swelling
  • clumps of calcifications in the prepatellar soft tissues in chronic cases 3

Hypoechoic fluid, sometimes containing debris, is noted anteriorly to the patellar surface 2.

Oval shaped fluid-filled sac is seen anterior to the patella and displays low T1 and bright T2/STIR signal intensity. When hemorrhage occurs T1 signal increases and T2 GRE signal reduces. The wall of the bursa may show increased thickness and irregularity.

Local injection of non-steroid anti-inflammatory drugs and steroids or local application of ice, and finally bursectomy in resistant cases.

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