Calcific prepatellar bursitis
Housemaid by profession, hard swelling over the patella with pain and difficulty during walking.
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Frontal and lateral radiographs of left knee joint shows multiple, punctate calcifications in the prepatellar and infrapatellar regions.
Calcific prepatellar bursitis or housemaid's knee is a chronic condition characterized by dystrophic calcifications in a chronic inflamed prepatellar bursa, which is a thin synovial lined superficial bursa anterior and slightly inferior to the patella 1.
The common causes are repetitive major or minor trauma over the knee joint, crystal deposition disease and bursal septic or pyogenic process. It is particularly common in housemaids who have to kneel continuosly for most part of the day.
The usual presenting symptoms are knee pain and swelling which increase on walking and subside on rest. The occupational history is a significant clue to the diagnosis as it is more common in carpet layers, sports person, miners, roofers, plumbers and housemaids.
The appearance of multiple punctate calcification in the prepatellar region can also be seen in gout and scleroderma 2. Also, this appearance may sometimes mimic a soft tissue sarcoma 3.
Conservative management includes pain alleviation by NSAIDs or cortisone injection. Definitive treatment consists of surgical removal of bursa which usually has high recurrence rate.
- 1. Hansen TB, Pless S. Calcifying pre-patellar bursitis. Presentation of a case involving both knees. Ugeskr. Laeg. 1994;156 (25): 3780. Pubmed citation
- 2. Stahnke M, Mangham DC, Davies AM. Calcific haemorrhagic bursitis anterior to the knee mimicking a soft tissue sarcoma: report of two cases. Skeletal Radiol. 2004;33 (6): 363-6. doi:10.1007/s00256-003-0743-9 - Pubmed citation
- 3. González LA, Ramírez FA, Gómez FA et-al. Prepatellar and preolecranon subcutaneous calcifications in scleroderma. J Clin Rheumatol. 2012;18 (2): 111. doi:10.1097/RHU.0b013e31824a4d4b - Pubmed citation