You may know prepatellar bursitis by its more common names of Housemaid’s Knee, Carpenter’s Knee or Carpet Layer’s Knee. These names might give you a clue as to how the condition develops.
What causes prepatellar bursitis?
Prepatellar bursitis is inflammation of the fluid-filled sac (the bursa) at the front or just below your kneecap (patella). Swelling occurs when the bursa becomes irritated or damaged, or as the result of an infection. This can cause the lining of the bursa to thicken and extra fluid to collect beneath the skin, resulting the characteristic puffy swollen appearance. It is a common condition that is normally mild and tends to go away by itself without treatment. However, in some cases it can be serious so it is important not to ignore it.
How does it occur?
There are two forms of prepatellar bursitis – acute and chronic. Acute prepatellar bursitis occurs when the bursa is damaged due to some kind of trauma, such as a heavy blow to the knee or an infection. This might be caused by a fall, being hit hard on the knee or by an insect bite or a cut that becomes infected. Conditions like gout and rheumatoid arthritis can predispose you to prepatellar bursitis.
In contrast, chronic bursitis is an overuse injury that occurs from repeated pressure on your knee, such as frequent kneeling. It is easy to see how certain jobs like carpentry, carpet fitting or plumbing, might make someone susceptible to this condition.
Who is at risk of prepatellar bursitis?
Although the condition can affect anyone of any age, it is most commonly seen in men aged between 40 and 60. As well as particular professions having an increased risk of prepatellar bursitis, it is also linked to hobbies like gardening. While overuse injuries are particularly common in adults, children are more likely to develop an infection of the prepatellar bursa.
Symptoms of prepatellar bursitis
The most obvious symptom is swelling around the kneecap. You will normally be able to feel the fluid beneath the skin and, if left untreated, this swelling may increase. If you develop a severe case of prepatellar bursitis, it can affect your ability to bend and straighten your knee. The condition is not always painful although some people say their knee feels achy while others experience pain if they try to kneel or bend the knee. If prepatellar bursitis is caused by an infection you may experience symptoms of a fever and your knee may feel hot to the touch or appear red.
Diagnosing prepatellar bursitis
Your doctor will carry out a physical examination and ask how and when the symptoms began. If they believe you might have an infected bursa, they might use a fine needle to collect a sample of the fluid which is sent away to be checked for signs of infection. Other types of diagnostic testing might be used to rule out other possible causes of swelling, such as a fracture or soft tissue injury. If your doctor is concerned you may be sent for an X-ray, CT scan or MRI scan.
Treating prepatellar bursitis
Treatment will depend on the cause and severity of the condition. A severely infected bursa which spreads in the blood is a serious and potentially life-threatening condition. If you have this you will be given antibiotics, either in pill form or intravenously and, if these fail to treat the infection properly, you may need to have the infected bursa surgically drained.
However, most forms of prepatellar bursitis are mild and easily treated. You will need to rest and, in particular, avoid doing whatever activity caused the problem to arise in the first place. Use an ice pack to reduce the swelling and keep your leg elevated. Anti-inflammatories can help to reduce the inflammation and relieve pain. If these at-home measures don’t provide sufficient relief, in the absence of active infection your doctor may offer an injection of corticosteroids into the affected area to reduce the inflammation and relieve pain.
It is important not to ignore the symptoms of prepatellar bursitis as they could worsen if left untreated and, in the case of infection, they could have serious consequences.
Preventing prepatellar bursitis
If you have a job that involves frequent kneeling, try using a kneeling cushion or wearing kneepads to relieve pressure on your knees. If you have used your knees a lot at work or during an exercise regime, use an icepack to reduce the risk of swelling, and rest with your legs elevated. Be mindful that an insect bite or cut around the knee could cause an infection to develop. Keep the area clean and be aware of any signs of infection.
If you are concerned about prepatellar bursitis and would like advice on diagnosis or treatment, contact us.
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