BURSITIS AROUND THE KNEE JOINT

Bursitis is inflammation of bursae. Bursae are sac like structures that are lined with synovial membrane.

They are present around the joints at places where tendons and muscles move in close proximity to bone. There function is to allow the smooth movement of muscles and tendons located close to bone. They may or may not communicate with the joint.

Before reading further it would be a good idea to see the relevant Knee Anatomy(skip this if you have already done so).

Bursa are of two types

• those naturally occurring in the body since birth
• those that develop at places of repeated friction and pressure, called Adventitious bursae

Both the types are affected by similar conditions.

Common causes include

• TRAUMA. It can be acute or chronic (repetitive) trauma
• INFECTION. Acute or chronic
• RHEUMATOID ARTHRITIS
• GOUT
• OSTEOARTHRITIS

Symptoms include

• pain and swelling
• fever (in infection)
• limitation of movement

All the symptoms may or may not be present, depending on the type. Fever is present in infective type. Swelling is more in acute type. Other symptoms of gout, rheumatoid arthritis and osteoarthritis will be present in bursitis caused by these diseases.

General treatment measures include

• rest
• use of heat and cold
• compression bandage or stocking
• elevation of the limb(reduces swelling)
• medicines to reduce inflammation and pain

Definitive treatment is directed at the cause.

• In acute traumatic type, blood or blood mixed fluid in the bursa is removed with a syringe and steroid is injected into it.
• In chronic type the underlying cause of repetitive trauma is first removed, then if required the bursa is aspirated and steroid injected.
• In infective cases appropriate systemic antibiotics are given, and if there is inadequate response, then pus can be aspirated or drained from the bursa. In chronic infection the bursa may require excision.
• In bursitis due to gout, rheumatoid arthritis and osteoarthritis treatment of the respective disease is started. This itself is usually sufficient for the inflamed bursa.
• For adventitious bursa, removal of the cause of repeated friction or pressure is required. For example, excision of bony prominence such as bunion or osteochondroma (developmental anomaly of bone).

Now lets look at a few common types of bursitis around the knee joint.

• Prepatellar: This bursa is located over the knee cap. When inflamed and painful it is also called as "housemaid's knee."
• Infrapatellar: This bursa is located below the patellar tendon. When inflamed it produces swelling in the lower part of the knee, in front.
• Popliteal or Baker cyst: This is caused by inflammation and collection of fluid in a bursa located on the posterior aspect of the knee joint. It is common in osteoarthritis and rheumatoid arthritis. Treatment is directed to the underlying cause. Surgical excision may be required.
• In children these cysts may resolve spontaneously with time. Hence in children, if they are asymptomatic, they should be left alone.

Fequently Asked Questions

Can the bursitis recur?

Yes it can. Chances are least in the infective type after appropriate antibiotics and drainage of fluid. Other types can recur.

When should I contact my doctor?

If your symptoms persist for more than 48 hours or you have fever then you should contact your doctor.

Other causes of knee pain include...

Knee Osteoarthritis

Patella Fracture

Meniscal Injury

Ligament Injury

Knee Anatomy

Go back to Knee Pain from Knee Bursitis