Bursitis

Question 1

Infrapatellar bursitis associated movement

Answer 1

-Associated with kneeling

Question 2

Prepatellar bursitis associated movement

Answer 2

Associated with more upright kneeling

Question 3

Presentation of bursitis

Answer 3

-Localised redness
-Swelling
-Marked tenderness anterior to patella or patellar tendon (can be painless in chronic bursitis)
-Fluctuant (movable and compressible), does not affect the range of motion
-Difficulty kneeling or walking
-Fever (more likely in septic bursitis)

Question 4

Risk factors for bursitis

Answer 4

-History of trauma
-Occupational or recreational activities that involve repetitive or prolonged kneeling
-RA or gout
-Immunocompromised/ systemic corticosteroid treatment
-Diabetes

Question 5

Investigations of bursitis

Answer 5

-Bursal aspiration if suspected septic or crystal-induced bursitis
-X-ray if bony pathology suspected
-Blood tests: CRP/ESR (spetic), uric acid, blood glucose, antibodies

Question 6

Management of bursitis

Answer 6

-Ice to reduce swelling
-Activity modification
-Simple analgesia (paracetamol/ NSAIDs)
-Bursal aspiration if large effusion
-Corticosteroid injection
-Surgery