Anatomy
There are numerous bursae around the knee that serve the purpose of reducing pressure on muscles, tendons and ligaments where they are in close contact with bone.
One of the most common mucosal sacs that can become irritated is the bursa on the front of the kneecap.
Cause of the problem
With repetitive strain (crawling on your knees) or impact, the bursa can become ‘inflamed’ (inflamed) and produce increased fluid, swelling and pain. Although the condition is called mucosal inflammation, there is usually no infection in the bursa.
Symptoms
Pain localised to the front of the kneecap, where a swelling can sometimes (but far from always) be felt. The pain is aggravated when bending the knee and by pressure on the kneecap.
Examination
In mild cases, the diagnosis is usually made on clinical examination alone. For more severe pain or lack of progress, a medical examination should be performed, especially if there is redness and increasing tenderness (suspected infection (purulent bursitis) to confirm the diagnosis and start any treatment.
If there is any doubt about the diagnosis, an ultrasound scan can be performed, which is best suited to confirm the diagnosis, and if infection is suspected, the fluid in the bursa can be drained and sent for examination.
Treatment
Treatment primarily involves relief from pain-inducing activity and gradual rehabilitation within the pain threshold. If no progress is made despite regular rehabilitation, it can be supplemented with anti-inflammatory drugs (NSAIDs) or injection of adrenal cortex hormone into the bursa.
Surgery is usually not indicated. If infection is detected, the infection should be drained and treated with antibiotics.
Rehabilitation, specific:
Usually, sports activity can be resumed once the pain and swelling have subsided.
Complications
If the progress is not smooth, you should consider whether the diagnosis is correct or if there are complications.
In particular, the following should be considered:
- Outer collateral ligament rupture
- Inner collateral ligament rupture
- Outer collateral ligament rupture
- Rupture of the posterior cruciate ligament
- Meniscus lesion
- Inflamed mucosal fold
In rare cases, the mucosa can become infected with bacteria. This is a serious condition where the bursa becomes red, warm and increasingly swollen and tender. This condition requires immediate medical attention and treatment.
