Knee Bursitis (Housemaid’s Knee)

Knee bursitis

Knee bursitis is inflammation of a small sac of fluid called a bursa. There are a number in the knee joint and their function is to lubricate movement between tendons and bone. The most common is prepatellar bursitis, also known as Housemaid’s knee.

Symptoms

Causes & anatomy

Treatment


Symptoms of prepatellar bursitis

  • Symptoms of Housemaid’s knee include pain and tenderness at the front of the kneecap and just below it.
  • The kneecap or patella may be swollen and warm to the touch.
  • Kneeling may be painful, hence the term housemaids knee.
  • An abscess or lump may be visible over the patella.
  • If the injury becomes chronic then there may be a tender lump floating underneath the skin on the kneecap.

What is knee bursitis?

knee bursa - bursa in the knee joint

A bursa is a small sack of fluid found in the body. Their function is to aid movement by lubricating movement between tendon and bone. There are a number of them in the knee joint alone.

The more common bursitis injuries of the knee are prepatellar bursitis (also known as housemaids knee), and Infrapatella bursitis.

Housemaid’s Knee also known as prepatellar bursitis or knee bursitis is a swelling of the bursa or small sack of fluid at the front of the patella (kneecap). It can be acute (sudden onset) or chronic, where it occurs gradually over time.



Causes

Bursitis can be acute (sudden onset) or chronic:

Acute knee bursitis

Acute prepatellar bursitis can be caused by a direct blow or fall on the knee. This ruptures blood vessels which bleed into the bursa causing swelling and triggering an inflammation reaction in the walls of the bursa.

Subsequently, the walls may then thicken, causing tenderness that may remain even after the swelling has reduced.

Acute knee bursitis can also be triggered by an infection as a result of a surface injury, such as a skin wound over the kneecap. In this case, bacteria may spread into the fluid within the pre-patellar bursa causing infection.


Chronic knee bursitis

Chronic bursitis is a longer-term problem which may recur over a period of time. Repeated damage to the knee for example from kneeling or work that involves a lot of pressure on the kneecap thickens the walls of the bursa causing irritation.



Treatment for knee bursitis

Acute injuries

  • Acute prepatellar bursitis should be treated as soon as possible with rest and application of ice or cold therapy.
  • Ice can be applied for 10 minutes every couple of hours for the first 24 to 48 hours, especially if it is painful.
  • Avoid kneeling down or applying any pressure to the knee.
  • A doctor may prescribe NSAID’s or anti-inflammatory medication such as Ibuprofen.  Always check with a doctor before taking medication.

Chronic injuries

  • If acute bursitis does not respond to treatment or has been present for a number of days or weeks, then as with an acute case avoid any aggravating movements such as kneeling.
  • Wear knee pads or padded knee supports to protect your knee.
  • If the swelling persists then a medical professional may aspirate some of the fluid within the bursa. This involves sucking the fluid out with a needle and syringe.
  • In cases where the bursa has become infected then antibiotics may be prescribed.
  • In more serious cases then surgery may be indicated to completely remove the bursa.

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