Knee Bursitis

 

The knee bursa is a small, fluid filled sac located between the front of the patella (knee cap) and the overlying skin. The bursa allows the knee cap to slide freely underneath the skin as we bend and straighten the knee. This is an inflamed bursa over the top of the knee cap. When the bursa becomes inflamed, it is called bursitis, which causes pain, swelling, tenderness and a lump in the area on the top of the knee cap. It may be difficult to kneel down and put the knee the floor due to the tenderness and swelling. Types of knee bursitis include suprapatellar, prepatellar (most common), and infrapatellar. Knee bursitis can be caused by trauma such as a direct injury or a fall into the knee which damages the bursa with the development of sudden large swelling. Knee bursitis can also be caused by occupational kneeling. Bursitis is chronic and develops slowly as seen in carpet layers, tilers, and wrestlers. Infection can cause knee bursitis as well. Inspect the bursa for any breaks in the skin leading to infection. Red, hot, painful, and swollen bursa is a sign of possible infection. Wrestlers may have abrasions of the knee, and this can lead to knee bursitis that may be infected. Inflammation of the bursa can also cause knee bursitis. Treatment of knee bursitis includes anti-inflammatory medications, ice therapy, aspiration, or surgery. Do aspiration if infection is suspected or confirmed. Aspirate first before you give antibiotics and send the fluid for culture and crystals. Surgery is debridement and excision of the bursa may be needed. Protective covering should be placed around the knee while avoiding activities that aggravate the condition.