Knee bursitis

Knee bursitis (Prepatellar bursitis) is the inflammation or irritation of the bursa which is located between the tissues (bone, muscle, tendon, and skin). It is also referred as ‘housemaid's knee,’ ‘roofer's knee,’ and ‘carpet layer's knee’. Bursa is a fluid filled sac which is located near the knee joint. The fluid sac reduces friction, rubbing, and irritation between the joints. The fluid filled pack like structure acts as a lubricating source and cushions the pressure between the joints. There are 11 bursae in each knee. Knee bursitis occurs mostly over the kneecap or inside the knee below the joint. Knee bursitis can limit the mobility of the joint. Knee bursitis is commonly observed in people who work by kneeling for longer periods. It is common in professions such as carpet layers, gardeners, roofers, plumbers, and sports persons.

Signs and Symptoms of knee Bursitis

The symptoms of knee bursitis include

  • Pain, redness, and tenderness in the knee
  • Warmthness in the knee
  • Swollen area in the knee
  • Limited movement of the knee
  • Fever (due to septic bursitis)

Prevention of Knee Bursitis

Knee bursitis can be prevented by following some simple measures such as

  • Wearing kneepads while on work or during sports
  • Resting the knees periodically
  • Avoiding prolonged stress on the knees
  • Wearing knee pads
  • voiding excessive squatting
  • Stretching and relaxing the legs in between the activities
  • Applying ice packs on knees after workout
  • Elevating the legs when in rest

Causes of Knee Bursitis

Knee bursitis occurs when the bursa becomes inflamed or infected. The inflammation can be due to injury or repetitive movement of the joint. The infections can occur due to attack of bacteria at the puncture wounds. The bacterium which usually causes knee bursitis is Staphylococcus. Knee bursitis due to infection from bacteria is usually called as septic bursitis. Knee bursitis can be caused by infection of bursa, direct trauma to the knee, repeated pressure on knee, continuous and frequent pressure on knee, complications such as gout, rheumatoid arthritis, and osteoarthritis.

The diagnosis of knee bursitis starts by a physical exam of the knee. During the physical examination, the doctor will inspect the knee by pressing gently on different areas and observes for swelling and warmthness and pain upon pressing. The comparison of both the knees helps to determine the level of inflammation in the knee. The doctor determines the range of motion of the knee joint by moving the knee in different positions. Some imaging tests are used to diagnose knee bursitis. They include:

X-ray: X-rays are useful in identifying bone fracture, tumor or arthritis. Bursae are not visualized by X-rays.
Ultrasound: High-energy sound waves are used to produce images of the joints visualize swelling in the affected bursa.
Magnetic resonance imaging (MRI): High-frequency radio waves and a strong magnetic field are used to produce detailed images of whole body. Bursae can be visualized by MRIs.
Aspiration Test: To identify if the swelling of the knee area is due to infection in the bursae, the doctors takes the sample of bursa fluid by inserting an aspiration needle into the affected area. The laboratory testing of the sample bursa fluid reveals the infection by the presence of bacteria in the sample fluid.

Depending on the cause of knee bursitis, the doctors may recommend different type of treatments. If it is due to inflammation of the bursa, the doctors suggest following methods to relieve pain.

Rest: The doctors suggest discontinuing the activities that may worsen the symptoms. Resting of the leg is suggested to relieve pain and inflammation of the knee.
Ice Packs: The doctors suggest applying ice packs on the knee at regular intervals of 3 or 4 times a day for 20 minutes at a time to relieve the pain and inflammation. The ice packs can reduce swelling if the knee is rested for prolonged periods without activity.
Elevation: The doctors suggest elevating the affected leg while in rest to relieve pain and inflammation.
Exercises: The doctors suggest some exercises to improve the flexibility and strengthen the muscles of the knees.
Medications: The doctors suggest take anti-inflammatory medications, such as naproxen or ibuprofen to relieve inflammation and pain. If the bursitis is caused due to infection, then the doctors suggest antibiotics.

Some invasive treatments for knee bursitis include:

Corticosteroid Injection: If the bursitis does not respond to basic treatments, the doctor may suggest corticosteroid injections into an affected bursa to reduce inflammation.
Aspiration: It is the technique of removal of excess fluid from the bursa. It is used to treat inflammation of the bursa. The process is carried out with a aspiration needle. This process may cause short-term pain and swelling in the knee. Knee immobilizers are suggested after the treatments for a short period reduce the chances of recurrent swelling.
Surgery: If the bursitis is chronic and does not respond to the treatments, then the doctor may suggest the surgical removal of the bursa.