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Infrapatellar Bursitis

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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
    • Infection[1]
    • Crystal disease including Gout
    • Trauma

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

Radiograph demonstrating significant pre- and infra-patellar soft tissue edema

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

Short axis view of intrapatellar bursa with well defined fluid collection

Radiology

Ultrasound

  • Can be used to help diagnose injury
  • Findings
    • Discrete, well defined fluid collection anterior the patella tendon

MRI

Sagittal view of knee MRI showing well defined fluid collection anterior to patella tendon
  • Findings
    • Fluid collection that projects exophytically, anterior to the patellar tendon
    • Localized with well defined fluid collection

Classification

  • Not applicable

Management

Nonoperative

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


References

  1. 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
Categories: