Prepatellar bursitis

Also known as housemaid’s knee is an inflammation of the knee bursa located between the patella and the overlying skin that presents with swelling but minimal discomfort.

Caused by trauma or friction from repetitive kneeling.

Management includes aspiration and drainage of bursa fluid.

Following aspiration a compression wrap to the knee is applied.

Patients should avoid trauma and repetitive kneeling.

Bursal fluid should be Gram stained, cultures and evaluated for crystals and white blood cells.

A corticosteroid injection may be considered for patients with recurrent or chronic disease.

X-ray films of the knee are not required for a diagnosis and seldom affect management.

Most patients respond to aspiration and NSAIDs.

5% to 10% of patients do not respond to conservative treatment and may require bursectomy.

Patients should use use a kneeling pad or cushioned knee protectors and take periodic breaks.

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