Patella Butsitis

Question 1

What is a bursa?

Answer 1

A small fluid filled sac that is found on horny prominences providing cushioning and lubrication.

Question 2

Where are bursa found?

Answer 2

Where moving structures are; between tendon and bone, bone and skin, muscles and bone, ligaments and bone.

Question 3

What is bursitis?

Answer 3

This is the inflammation of the bursa.

Question 4

Common locations of bursitis in the body?

Answer 4

Shoulder joint
Hip joint
Elbow
Knee joint

Question 5

Why is the infrapatellar bursa also called Clergyman’s knee?

Answer 5

Clergyman’s knee is also a condition where swelling and pain around the knee is present, but this is caused by repeated or prolonged kneeling in a different position than what causes housemaid’s knee.

Pain is perceived below the knee

Question 6

What is the most common bursitis?

Answer 6

Prepatella bursitis

Question 7

Prepatella bursitis is also called?

Answer 7

Housemaids knee, miners knee

Question 8

What is prepatella bursitis?

Answer 8

This is a chronic condition that occurs over a long period of time that involves the irritation of the knee cap causing fluid build up in that area causing it to swell and put pressure on near by structures.

Question 9

What causes prepatella bursitis?

Answer 9

○ Sustained pressure of body weight due to frequent
kneeling. (Plumbers, roofers, carpet layers, coal miners, gardeners & handicapped persons who depend on knee walking are at great risk for developing the condition)

○ Bacterial infection (breached skin– bacteria enters bursa sac causing infection)

○ Direct blow to the front of the knee (common in athletes)

Question 10

What are the clinical features of prepatella bursitis?

Answer 10

The 5 features of Inflammation:

Pain
Heat
Dysfunction
Redness
Swelling

Question 11

What medical history will you take?

Answer 11

Severity of pain (SOCRATES)
Signs of infection (fever or chills)

Question 12

What tests will you carry out to confirm findings?

Answer 12

Aspiration ( withdrawing fluid using a needle)

MRI
CT scan
X-Ray

Question 13

What treatment?

Answer 13

Ice (20 min max)
▸ Rest: crepe/ pressure
Surgery Postoperative management
bandage
▸ Analgesic anti inflammatory
drugs
▸ Avoid: kneeling,pressure
positions & movements at
knee
▸ Electrical stimulation: avoid
disuse atrophy (quads)
▸ bursal aspiration
▸ intrabursal steroid
excised surgically
▸ End of 1 week- small range isometrics to quads within pain free range
▸ Self assisted relaxed passive knee swinging
▸ Gentles passive movements: start to improve patellar mobility
injection