Hemorrhagic superficial infrapatellar bursitis

Case contributed by Joe Ghattas Yazbeck
Diagnosis almost certain

Presentation

Anterior knee swelling and pain, increasing in size over 2 years associated with repetitive trauma.

Patient Data

Age: 30 years
Gender: Male

A 7.4 x 6 x 3.8 cm (CC x transverse x AP) hyperintense STIR, hyperintense T1, well-circumscribed thick walled collection with internal fine septations in the anterior subcutaneous tissue, superficially to the distal insertion of the patellar tendon, causing posterior bowing of the latter with no evidence of abnormal signal intensity. A small nipple-like projection is noted in its inferomedial portion. Mild surrounding soft tissue edema is also noted. No post gadolinium enhancement is noted.

Findings are consistent with hemorrhagic superficial infra-patellar bursitis (clergyman's knee).

Mild supra-patellar joint effusion.

Intra-substance high STIR signal intensity is noted in the posterior horn and body of the medial meniscus (appreciated on the coronal STIR sequence), consistent with myxoid degeneration.

Case Discussion

This case demonstrates typical features of superficial infrapatellar bursitis complicated by hemorrhage, which was completely excised by surgery.

Case supervised by Dr Ali Chaaban FRCR.

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