Skip to Main Content

++

  • Infrapatellar bursitis
  • Housemaid’s knee

++

  • 726.65 Prepatellar bursitis

++

  • M70.40 Prepatellar bursitis, unspecified knee

++
++

Description

++

  • Localized inflammation of the prepatellar bursa
  • Bursa fills with blood and serous fluid as response to either acute or repeated micro trauma.
  • Presents as pronounced, local swelling isolated to the anterior knee.

++

Essentials of Diagnosis

++

  • Result of single episode of trauma or repeat trauma to the anterior knee when in a flexed position
  • Bursitis is commonly related to occupation or specific activity that causes rubbing or pressure on the anterior knee from a hard surface.
  • Swelling is contained to bursa which results in the visualization of a swollen appearance on both sides of the patella tendon.
  • Patients often note focal pain to palpation of swollen bursa, decreased range of motion, or inability to bear weight on the flexed knee.
  • Differential diagnosis is essential due to presence of infections to this area.
  • Exquisite swelling, marked tenderness, and redness or heat may be indicative of differential diagnosis.
  • When chronic, often associated with occupation (maid) or prolonged activity (tile installer) which places flexed knee on hard surface
  • When acute, often associated with acute blow when the knee is flexed (athletes)

++

General Considerations

++

  • Full history of symptoms and medical history screening will ensure appropriate diagnosis.
  • Isolated diagnosis related to acute or chronic activity (pressure to the anterior flexed knee by a hard surface) and focal swelling/pain
  • Marked tenderness or swelling with acute onset may signal underlying fracture.
  • Redness or heat may be indicative of infection.

++

Demographics

++

  • Occurs primarily in adults but can occur in children and athletes of any age

++

Signs and Symptoms

++

  • Point tenderness to the anterior knee
  • Focal swelling
  • Stiffness with flexion
  • Pain with rubbing or light pressure to the anterior knee
  • Pain with focal pressure
  • Knee ROM (usually flexion) can be reduced
  • Pain and swelling can be either insidious or acute
    • Occasionally, swelling can be spontaneous and without pain
  • Possible reduction in strength due to pain and inflammation.
  • Pain in anterior knee
  • Increased swelling throughout the day
  • Tenderness changes position with tendon movement during extension
  • Thickening of the tendon
  • Decreased extension strength

++

Functional Implications

++

  • Inability to climb stairs or ladder
  • Inability to push-off during ambulation
  • Decreased ability to kneel
  • Decreased squat depth

++

Possible Contributing Causes

++

  • Intrinsic risk factors
    • Decreased knee flexion ROM
    • Decreased quadriceps strength
    • Greater pronation/calcaneal varus and faster rate of maximum pronation
    • obesity
  • Extrinsic risk factors
    • Occupational factors with kneeling and weight-bearing on the anterior knee

++

Differential Diagnosis

++

  • Tendon rupture
  • Tendon partial tear
  • Bone spur
  • Chondromalacia
  • Tendinitis
  • Meniscal tear
  • ACL ligament ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPhysiotherapy Full Site: One-Year Subscription

Connect to the full suite of AccessPhysiotherapy content and resources including interactive NPTE review, more than 500 videos, Anatomy & Physiology Revealed, 20+ leading textbooks, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPhysiotherapy

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.