Summary about Disease
Infrapatellar bursitis is an inflammation of the infrapatellar bursa, a fluid-filled sac located below the kneecap (patella), in front of the patellar tendon. It is classified into two main types: superficial infrapatellar bursitis, affecting the bursa between the skin and the patellar tendon, and deep infrapatellar bursitis, affecting the bursa between the patellar tendon and the tibia (shinbone). The inflammation causes pain and swelling in the front of the knee, often exacerbated by activities involving kneeling or direct pressure on the knee.
Symptoms
Pain in the front of the knee, especially below the kneecap.
Swelling and tenderness in the area below the kneecap.
Pain that worsens with kneeling, squatting, or walking uphill.
Stiffness and limited range of motion in the knee.
Possible redness and warmth in the affected area.
A visible, palpable lump or fluid-filled sac in front of the knee.
Causes
Repetitive kneeling or crawling: Common in occupations like carpet laying, gardening, and plumbing.
Direct trauma to the knee: A blow or fall directly onto the kneecap area.
Overuse: Repeated stress on the knee joint from activities like running or jumping.
Infection: Septic bursitis (rare) caused by bacteria entering the bursa.
Underlying conditions: Gout, rheumatoid arthritis, or other inflammatory conditions.
Poor footwear or improper technique: During physical activities.
Medicine Used
Pain relievers: Over-the-counter medications like ibuprofen (Advil, Motrin) or naproxen (Aleve) to reduce pain and inflammation. Acetaminophen (Tylenol) can help with pain but does not reduce inflammation.
Corticosteroids: Injections of corticosteroids into the bursa to reduce inflammation.
Antibiotics: If the bursitis is caused by an infection (septic bursitis).
Topical NSAIDs: Creams or gels containing nonsteroidal anti-inflammatory drugs can be applied directly to the affected area.
Is Communicable
No, infrapatellar bursitis is not communicable. It is not caused by a virus or bacteria that can be spread from person to person, unless there is a septic bursitis which could spread infection locally but is still not typically considered communicable in the sense of a cold or flu.
Precautions
Avoid activities that aggravate the pain: Minimize kneeling, squatting, and other activities that put pressure on the knee.
Use knee pads: When kneeling is unavoidable, wear knee pads to protect the bursa.
Maintain a healthy weight: Excess weight puts additional stress on the knee joint.
Proper warm-up and stretching: Before engaging in physical activities.
Strengthening exercises: To support the knee joint and prevent recurrence.
Avoid prolonged static positions: Vary positions frequently to prevent stiffness.
How long does an outbreak last?
The duration of an infrapatellar bursitis outbreak can vary depending on the severity of the inflammation, the underlying cause, and the treatment received.
Mild cases: With rest, ice, and over-the-counter pain relievers, symptoms may improve within a few days to a week.
Moderate cases: May take several weeks to a few months to fully resolve, especially if activities that aggravate the condition are continued.
Severe or chronic cases: If the bursitis is due to an underlying condition, infection, or repeated trauma, it may take several months or longer to heal, and may require more aggressive treatment, such as corticosteroid injections or even surgery.
How is it diagnosed?
Physical Examination: A doctor will examine the knee, looking for swelling, tenderness, and range of motion limitations.
Medical History: The doctor will ask about your activities, injuries, and any underlying medical conditions.
Imaging Tests:
X-rays: To rule out other conditions, such as fractures or arthritis.
MRI (Magnetic Resonance Imaging): To visualize the bursa and surrounding tissues, helping to identify inflammation and rule out other problems.
Ultrasound: Can also visualize the bursa and surrounding tissues.
Bursa Aspiration: If infection is suspected, fluid may be drawn from the bursa for analysis.
Timeline of Symptoms
The timeline of symptoms can vary, but a typical progression might look like this:
Initial Stage: Gradual onset of pain below the kneecap, often after an activity involving kneeling or direct pressure. Mild swelling may be present.
Progression: Pain worsens with activity, and swelling becomes more noticeable. Stiffness in the knee may develop.
Acute Flare-up: Sudden increase in pain and swelling, often triggered by a specific event or activity.
Chronic Stage: Persistent low-grade pain and swelling that may flare up intermittently with activity. Limited range of motion may become more pronounced.
Important Considerations
Differential Diagnosis: It's important to differentiate infrapatellar bursitis from other knee conditions like patellar tendonitis (jumper's knee), osteoarthritis, or meniscal tears.
Early Intervention: Addressing the condition early can help prevent it from becoming chronic.
Activity Modification: Adjusting activities to avoid kneeling and other aggravating factors is crucial for recovery.
Physical Therapy: Physical therapy exercises can help strengthen the muscles around the knee and improve range of motion.
Possible Complications: Untreated bursitis can lead to chronic pain, limited mobility, and the formation of adhesions in the bursa. Septic bursitis, if left untreated, can lead to serious infection.