Pre-Patellar Bursitis

Question 1

What population has an increased risk of septic/infectious bursitis?

Answer 1

1. Peds
2. Immunocompromised

Question 2

What causes Pre-patellar bursitis

Answer 2

1. Overuse
2. Direct blow to the area
3. Chronic friction
4. Crystal disease/gout

Question 3

Where is the prepatellar bursa located?

Answer 3

1. Anterior to the patella near the attachment of the patellar tendon

Question 4

Is the prepatellar bursa superficial or deep?

Answer 4

1. Superficial
   *will reduce friction
   *it is a flat synovial lined structure

Question 5

What is the difference between Prepatellar bursitis and an effusion

Answer 5

1. Prepatellar bursitis will swell out and around
   *feel squishy
2. Effusion will be inside the knee and feel firm

Question 6

How will a patient present with Prepatellar bursitis

Answer 6

1. Pain and swelling over anterior knee

Question 7

What are the PE findings>

Answer 7

1. Swelling anterior to the patella (sponge like)
2. Tender to palpation
3. Decreased knee flexion

Question 8

What are the labs to order?

Answer 8

1. Radiographs
   *for underlying fracture
2. CBC, protein, crystals, gram stain
   * Prepatellar bursitis is a common place of infection

Question 9

What is the treatment?

Answer 9

1. RICE
2. NSAIDS
3. Aspiration with or without cortisone (effective)
4. Surgical excision (failed conservative treatment)

***Do 1,2,3,4 in that order