Calcific prepatellar bursitis

Case contributed by Dr Rupesh Namdev

Presentation

Housemaid by profession, hard swelling over the patella with pain and difficulty during walking.

Patient Data

Age: 45-50
Gender: Female
X-ray

Frontal and lateral radiographs of left knee joint shows multiple, punctate calcifications in the prepatellar and infrapatellar regions.

Case Discussion

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.

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Case information

rID: 28783
Case created: 11th Apr 2014
Last edited: 15th Dec 2015
Inclusion in quiz mode: Included

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