Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Infrapatellar bursitisHousemaid’s knee ++ 726.65 Prepatellar bursitis ++ M70.40 Prepatellar bursitis, unspecified knee ++ 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated With Localized Inflammation +++ Description ++ Localized inflammation of the prepatellar bursaBursa 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 positionBursitis 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 surfaceWhen 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/painMarked 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 kneeFocal swellingStiffness with flexionPain with rubbing or light pressure to the anterior kneePain with focal pressure Knee ROM (usually flexion) can be reducedPain and swelling can be either insidious or acuteOccasionally, swelling can be spontaneous and without painPossible reduction in strength due to pain and inflammation.Pain in anterior kneeIncreased swelling throughout the dayTenderness changes position with tendon movement during extensionThickening of the tendonDecreased extension strength +++ Functional Implications ++ Inability to climb stairs or ladderInability to push-off during ambulationDecreased ability to kneelDecreased squat depth +++ Possible Contributing Causes ++ Intrinsic risk factorsDecreased knee flexion ROMDecreased quadriceps strengthGreater pronation/calcaneal varus and faster rate of maximum pronationobesityExtrinsic risk factorsOccupational factors with kneeling and weight-bearing on the anterior knee +++ Differential Diagnosis ++ Tendon ruptureTendon partial tear... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.