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Pre-patellar Bursitis
Housemaid's Knee


General Considerations

  • Prepatellar bursa is superficial bursa
  • Thin synovial lining
  • Located between skin and patella
  • Main function is to separate patella from patellar tendon and skin
  • Normally does not communicate with joint
  • Contains minimal amount of fluid
  • Inflammation of prepatellar bursa results in marked increase of fluid in bursa
  • Incidence of prepatellar bursitis greater in males than females


  • Direct trauma (eg, a fall on patella or direct blow to knee)
    • If acute, frequently due to small blood vessel rupture
  • Repetitive minor injuries (eg, repeated kneeling)
  • Septic or pyogenic process
    • Infection usually from Staphylococcus aureus from break in skin
    • More prevalent in children
    • Can be mistaken for pyogenic arthritis
  • Crystal deposition (eg, gout, pseudogout)
  • Occupation
    • Carpet layer
    • Wrestlers
    • Coal miner
    • Roofer
    • Plumber
    • Homemaker (housemaid's knee)

Clinical findings

  • Knee pain
  • Swelling
  • Redness
  • Difficulty walking
  • Relief of pain with rest
  • History of repetitive motion
  • History of occupation requiring excessive kneeling
  • History of a fall on knee or blunt trauma to knee

Physical findings

  • Patella tender to palpation
  • Fluctuance over lower pole of patella
  • Erythema
  • Crepitation
  • Decreased ROM

Imaging Studies

  • Plain radiographs
    • Soft tissue swelling
    • Calcification
      • Especially if hemorrhage into bursa
  • Computed tomography (CT) scan and magnetic resonance imaging (MRI)
    • Complex fluid collection anterior to knee in region of prepatellar bursa
    • Wall of bursa my be thickened and irregular


  • NSAIDs
  • Cortisone injection
  • Aspiration of bursa
  • Surgical removal of bursa
  • Kneepad
  • Has high recurrence rate 

 prepatellar bursitis

Prepatellar Bursitis. Frontal and lateral radiographs of both knees demonstrate multiple, punctate calcifications in the pre- and infrapatellar regions.

Kelly Allen, MD   eMedicine.com