About pre-patella bursitis
What is bursitis?
A bursa is a small sac filled with a jelly-like fluid. There are many bursae throughout the body, and they are normally found around joints and bones. Bursae act as cushioning, and help soft tissue glide over bones smoothly. Bursitis means inflammation within a bursa, which causes the bursa to swell and become painful.
What is pre-patellar bursitis? (also known as housemaid’s knee)
There are several bursae around the knee. Any one of these can become inflamed, though the pre-patellar bursa is the most commonly affected. This is found on the front of the knee, just over the knee-cap. You can see in the picture below where some of the bursae are around the knee.
What are the symptoms of pre-patellar bursitis?
- Pain and swelling over the front of the knee, swelling is usually soft and movable
- Tender to touch over the swelling
- Difficulty kneeling or fully bending your knee
- Swelling can last a few weeks but usually gets better with rest and time
- If you have a hot, red, or swollen knee, severe or worsening pain or any breaks in the skin around your knee, contact your GP
- If you have a fever (high temperature), feel shivery, feel sick or unwell this could be a sign of infection, you should see a GP urgently or call 111.
What causes pre-patellar bursitis?
- injury to the knee such as a fall or direct blow on to the knee during sport
- prolonged period of time spent on knees
- Infection: can occur inside the fluid of the bursa. This could follow a cut or scratch to the skin near the knee. This break in the skin allows bacteria (germs) to spread infection into the bursa.
Who gets pre-patellar bursitis?
- More common in tradesmen who spend long periods of time kneeling. For example, carpet fitters, concrete finishers and roofers.
- certain medical conditions put you at greater risk such as such as rheumatoid arthritis or gout
- more risk of it being an infected bursa in children, or in people with a weakened immune system – for example if you are taking steroids or are having chemotherapy
How is pre-patellar bursitis diagnosed?
Your doctor is usually able to diagnose pre-patellar bursitis by examining your knee. They may ask about your job, recent injuries, any other joint problems or medical conditions.
If an infection is suspected your doctor may suggest blood tests, and taking some fluid off the knee to be sent for testing. If the bursitis is caused by an infection, your GP will treat it with antibiotics.
What are the treatment options for pre-patellar bursitis?
If the bursitis is not caused by infection then symptoms should improve with the following treatment options:
- Rest and avoid kneeling on the knee
- Ice: Place an ice pack or bag of frozen veg wrapped in a damp tea towel on the area for around 10 minutes at a time and repeat every few hours during the day
- Simple painkillers (paracetamol or ibuprofen, consult with GP or pharmacist first)
- Using cushioning or knee pads to kneel on in future can help to prevent recurrence
- In some cases a steroid injection into the bursa may be considered if all other options have been tried and the problem still severely affects work or sport
- In some cases where all treatment options have been tried and the bursitis continues to be a big problem, then you may need referral to an orthopaedic surgeon. They may discuss surgery to remove the bursa called a ‘bursectomy’, but this type of surgery is very rare.
