Knee Bursitis (cont.)
How is prepatellar bursitis of the knee treated?
The treatment of any bursitis depends
on whether or not it involves infection. Aseptic prepatellar bursitis
can be treated with ice compresses, rest, and antiinflammatory
and pain medications. Occasionally, it requires aspiration
of the bursa fluid. This procedure involves removal of the fluid with a needle
and syringe under sterile conditions and can be performed in the doctor's office. Sometimes the fluid is
sent to the laboratory for further analysis. Noninfectious knee bursitis
can also be treated with an injection of cortisone medication
into the swollen bursa. This is sometimes done at the same time
as the aspiration procedure.
Septic bursitis requires even further evaluation and treatment. The bursal fluid can be
examined in the laboratory to identify the microbes causing the infection. It requires
antibiotic therapy, often
intravenously.
Repeated aspiration of the inflamed fluid may be required. Surgical
drainage and removal of the infected bursa sac (bursectomy) may
also be necessary.
What about the other knee bursae?
A second bursa of the knee is located just under the kneecap beneath the large
tendon that attaches the muscles in front of the thigh and the kneecap to the
prominent bone in front of the lower leg. This bursa is called the infrapatellar bursa, and when
inflamed, the condition is called infrapatellar bursitis. It is commonly seen
with inflammation of the adjacent tendon as a result of a jumping injury, hence
the name "jumper's knee." This condition is generally treated with ice, rest,
and oral antiinflammatory and/or pain medicines.
A third bursa of the knee is called the "anserine bursa."
It is located on the lower inner side of the knee. This bursa
most commonly becomes inflamed in middle-aged women. This condition is referred to as anserine bursitis. Anserine bursitis is particularly
common in those who are obese. These patients can notice pain in the inner
knee while climbing or descending stairs. Anserine bursitis is generally
treated with ice, rest, and oral antiinflammatory and/or pain
medicines, although cortisone injections are also given.
- A bursa is a fluid-filled sac that functions as a gliding surface to reduce friction between moving tissues
of the body.
- There are three major bursae of the knee.
- Bursitis is usually not infectious, but the bursa
can become infected.
- Treatment of noninfectious bursitis includes rest, ice,
and medications for inflammation and pain. Infectious bursitis is treated with
antibiotics, aspiration, and surgery.
References:
Clinical Primer of Rheumatology, Lippincott Williams & Wilkens, edited by William Koopman, et al., 2003.
Kelley's Textbook of Rheumatology, W B Saunders Co, edited by Shaun Ruddy, et al., 2000.
Last Editorial Review: 10/1/2008
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