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Infrapatellar Bursitis
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Contents
Other Names
- Superficial infrapatellar bursitis
- Clergyman's knee
- Vicar's knee
Background
- This page refers to bursitis of the superficial bursa anterior to the distal patellar tendon
History
Epidemiology
- Unknown
- Generally limited to case reports
Pathophysiology
- See: Bursopathies (Main)
- General
- Overall, poorly characterized in the literature
- Generally considered an inflammatory condition with fluid accumulation as a result of chronic stress
- Etiology
Associated Conditions
Pathoanatomy
- Superficial infrapatellar bursa
- Lies between the subcutaneous tissues and the superficial aspect of the Patellar Tendon
- Can exist as a single sac, or less commonly, multisegmented series of loculated sacs
Risk Factors
- Occupations/ Activities
- Kneeling
- Crawling
Differential Diagnosis
- Fractures
- Dislocations & Subluxations
- Patellar Dislocation (and subluxation)
- Knee Dislocation
- Proximal Tibiofibular Joint Dislocation
- Muscle and Tendon Injuries
- Ligament Pathology
- Arthropathies
- Bursopathies
- Patellofemoral Pain Syndrome (PFPS)/ Anterior Knee Pain)
- Neuropathies
- Other
- Bakers Cyst (Popliteal Cyst)
- Patellar Contusion
- Pediatric Considerations
- Patellar Apophysitis (Sinding-Larsen-Johnansson Disease)
- Patellar Pole Avulsion Fracture
- Tibial Tubercle Avulsion Fracture
- Tibial Tuberosity Apophysitis (Osgood Schalatters Disease)
- Proximal Tibial Metaphyseal Fracture
- Proximal Tibial Physeal Injury
Clinical Features
- History
- Patient will endorse anterior knee pain
- Often with a history of repetitive microtrauma from kneeling
- Physical Exam
- Palpable swelling inferior to the patella
- Special Tests
Evaluation
Radiology
- Standard Radiographs Knee
- Often normal
- Findings
- May show calcification of bursa in chronic cases
Ultrasound
- Can be used to help diagnose injury
- Findings
- Discrete, well defined fluid collection anterior the patella tendon
MRI
- Findings
- Fluid collection that projects exophytically, anterior to the patellar tendon
- Localized with well defined fluid collection
Classification
- Not applicable
Management
Nonoperative
- Relative rest
- NSAIDS
- Physical Therapy
- Compression Sleeve or Ace Wrap
- Aspiration / Injection
- Persistently swollen or painful bursa may require aspiration
- If considered non-infectious, consider Corticosteroid Injection
Operative
- Generally not indicated (case reports?)
Rehab and Return to Play
Rehabilitation
- Needs to be updated
Return to Play
- Needs to be updated
Complications And Prognosis
Prognosis
- Most patients can expect to make a full recovery
Complications
- Chronic pain
See Also
- Internal
- External
- Sports Medicine Review Knee Pain: https://www.sportsmedreview.com/by-joint/knee/
References
- ↑ Van den Bossche, Dorien, et al. "Case report: infrapatellar bursitis caused by Prototheca wickerhamii." Medical mycology case reports 1.1 (2012): 13-16.
Created by:
John Kiel on 10 June 2019 17:08:43
Authors:
Last edited:
4 October 2022 15:53:12
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