- Infrapatellar bursitis
- Housemaid’s knee
- 726.65 Prepatellar bursitis
- M70.40 Prepatellar bursitis, unspecified knee
- 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
- 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
- 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
- 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)
- 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
- Redness or heat may be indicative of infection.
- Occurs primarily in adults but can occur in children and
athletes of any age
- 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
- Inability to climb stairs or ladder
- Inability to push-off during ambulation
- Decreased ability to kneel
- Decreased squat depth
- Intrinsic risk factors
- Decreased knee flexion ROM
- Decreased quadriceps strength
- Greater pronation/calcaneal varus and faster rate
of maximum pronation
- Extrinsic risk factors
- Occupational factors with kneeling and weight-bearing
on the anterior knee
- Tendon rupture
- Tendon partial tear
- Bone spur
- Meniscal tear
- ACL ligament ...
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