Prepatellar bursitis (nonseptic): Difference between revisions

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==Background==
==Background==
*Occurs via repetitive kneeling on hard surfaces
*Generally occurs via repetitive kneeling on hard surfaces
*One of the more common sites for septic bursitis (especially in children)
*One of the more common sites for [[septic bursitis]] (especially in children)


==Clinical Features==
==Clinical Features==
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==Differential Diagnosis==
==Differential Diagnosis==
*[[Septic bursitis]]
{{Knee DDX}}
*[[Septic arthritis]]


==Treatment==
==Evaluation==
*NSAIDs, rest, heat
*Clinical diagnosis, based on history and physical exam
*Admit for IV abx if infected bursa is suspected
*There is currently no consensus on the optimal diagnosis strategy for prepatellar bursitis.  The majority of patients studied did receive an aspiration of fluid (82%), but those patients had a significantly higher rate of complications (persistent infection, secondary infection in initially aseptic bursae) than patients treated with antibiotics alone.<ref>Baumbach SF et al. Prepatellar and Olecranon bursitis: literature review and development ofa treatment algorithm.  Arch Orthop Trauma Surg.  (2014) 134: 359 - 370.</ref>
 
==Management==
*Supportive
**[[NSAIDs]]
**Rest
**Warm compresses
*IV [[antibiotics]] if infected bursa ([[Septic bursitis]]) is suspected
 
==Disposition==
*Outpatient


==See Also==
==See Also==
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*[[Bursitis]]
*[[Bursitis]]


==Source==
==References==
*Tintinalli
<References/>


[[Category:Ortho]]
[[Category:Orthopedics]]
[[Category:Sports Medicine]]

Revision as of 17:01, 18 October 2019

Background

  • Generally occurs via repetitive kneeling on hard surfaces
  • One of the more common sites for septic bursitis (especially in children)

Clinical Features

  • Mild pain
  • Swelling over lower pole of patella that may result in restricted ROM
    • May be so severe that must differentiate from a joint effusion

Differential Diagnosis

Knee diagnoses

Acute knee injury

Nontraumatic/Subacute

Evaluation

  • Clinical diagnosis, based on history and physical exam
  • There is currently no consensus on the optimal diagnosis strategy for prepatellar bursitis. The majority of patients studied did receive an aspiration of fluid (82%), but those patients had a significantly higher rate of complications (persistent infection, secondary infection in initially aseptic bursae) than patients treated with antibiotics alone.[1]

Management

Disposition

  • Outpatient

See Also

References

  1. Baumbach SF et al. Prepatellar and Olecranon bursitis: literature review and development ofa treatment algorithm. Arch Orthop Trauma Surg. (2014) 134: 359 - 370.