Prepatellar bursitis

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Overview
Prepatellar bursitis, also known as housemaid's knee, is a common cause of swelling and pain above the patella (kneecap), and is due to inflammation of the prepatellar bursa. This structure is a superficial bursa with a thin synovial lining located between the skin and the patella. The bursa develops within the first years of life as a result of mechanical pressure and friction, and it serves the purpose of reducing friction on underlying structures and allowing maximal range of motion in the knee. Aseptic prepatellar bursitis is commonly caused by repetitive work in a kneeling position, hence the name "housemaid's knee".

Inflammation of the prepatellar bursa may be aseptic (most common) or septic (e.g. bacterial infection), the septic variants being most common in children and immunocompromised individuals.

Prepatellar bursitis is more common in men than women.

Diagnostic Findings
(Images courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, CA)

Treatment
Aseptic bursitis is usually managed conservatively, but complicated cases may be treated with oral NSAIDs or corticosteroid injections when infection has been ruled out. Surgical excision is seldom necessary.

Acute bursitis can develop into a chronic issue if the cause is not identified and addressed.