Bursitis is a condition that causes inflammation and pain around the joints of muscles, tendons and bones. This happens when the bursa is inflamed and becomes swollen hence causing the pain. As the condition continues, its effects become clear. The affected area starts to turn red. Bursitis can attack any part of the body which has bursae like knees, shoulders, toes etc.
Bursa is a sac found in between joints around the bones, muscles or tendons. The sac is always filled with a fluid made up of synovial cells. The bursa acts as a lubricant between the joints to facilitate easy movement.
Prepatellar bursitis is a condition that targets the front bursa in the knee called patella. The condition causes inflammation and pain around the patella (kneecap). It causes the bursa around this part to swell hence causing irritation. There is an excess fluid buildup making the bursae swollen, hence those parts of the knee are subjected to excessive pressure.
Causes of Prepatellar Bursitis
• Infection- This is where certain infections are responsible for prepatellar bursitis. An example is Staphylococcus aureus which causes prepatellar bursitis among children.
• Acute trauma- This is where a person suffers direct traumas to the knee. Such traumas may originate from falling or by getting hit.
• Recurrent injuries- These are some of the injuries that occur slowly around the knee. They happen when someone is used to kneeling for a long time when washing carpets or even gardening. This applies excess pressure on the patella causing inflammation.
Signs and Symptoms of Prepatellar Bursitis
The condition can easily be mistaken with other infections but the following are its symptoms:
• During the first days of the infection there is little pain in the knee which increases with time. Swelling takes place and the skin around the knee starts to turn red.
• The patient experiences difficulty in walking and kneeling with time.
• Pain during the nights.
• When you touch the skin around the affected area of the patella, it will feel warm.
• Movement of the knee reduces.
• Increase in fever and signs of upset.
• Tenderness of the patella.
• Experiencing incision of the skin.
Diagnosis of Prepatellar Bursitis
The doctor will have a frank and clear discussion with you about the symptoms you experience. This will include from when you started having these symptoms, the amount of pain you are suffering and your tendency for developing this kind of bursitis. The doctor will also have queries concerning all symptoms of any other infection including high body temperature and shivering. This is because prepatellar bursitis which is brought on by an infection will need a different treatment.
When the doctor examines you, the knee that has been affected will be compared with the healthy knee. The doctor will move your knee through a range, check whether you have too much pain and will also check the area for tenderness. To identify a prepatellar, doctors use various methods such as,
• X-rays- These are not really used for detecting bursitis but rather used to rule out any case of bone fracture that might attribute to inflammation or pain.
• Aspiration- This is where the doctor drains the fluid from the bursa for testing. The test is used to rule out the possibilities of another infection.
• Imaging- This is used to check injuries on soft tissues. They may include Magnetic Resonance Imaging (MRI), ultrasound and Computer Tomography (CT).
Treatment of Prepatellar Bursitis
• Taking a break- This means that you have to stop doing any strenuous job you are doing. You are supposed to rest for awhile to give time for the bursa to heal. While resting you are only allowed to undertake simple exercises such as cycling.
• Medication- In some cases where you are unable to take a break and the condition is not too severe, it is advisable to use ant-inflammatory drugs. These may include ibuprofen and naproxen. Antibiotics can also be used.
• Use of Ice- Ice packs are used to relieve pain and reduce swelling. Apply ice packs at intervals of 10-15 minutes for 2-3 hours a day. It will reduce the swelling within a few days.
• Surgery- This is taken as the last step. It is done when the swelling does not stop. The doctor removes the inflammation in the patient.
If the bursa is still swollen and painful despite these steps, the doctor may want to aspirate it using a needle. Corticosteroid might be injected into the bursa. The strong medication has an anti-inflammatory effect and is much better than any drug ingested. If the bursa is infected, it will typically be treated with antibiotic medication at first. If the infection does not respond to the drugs at all, only then does it need to be drained using the surgical method.
Draining the bursa may also treat chronic swelling which causes disability, but if the swelling continues, your orthopedic surgeon may recommend surgical removal of the bursa. After surgery, the knee should regain its flexibility in a few days and normal activities can be resumed in a few weeks.
Prevention of Prepatellar Bursitis
- Resting your knees when you are engaged in strenuous work.
- Applying ice after workouts.
- Wearing protective pads when playing sports such as football to prevent injuries. You should stop at regular intervals to stretch the legs and rest the knees.
- Doing some activities differently will also prevent the application of unnecessary pressure on the knees.
The Bottom Line
Prepatellar bursitis is a condition which mostly affects the aged and the children. It is important to take precautions since most of its causes can be prevented. There are many different opinions about the kind of treatment more effective in case the prepatellar bursitis turns septic. Some say that surgical drainage is not necessary and that oral antibiotics are more than enough. Others say that the injected antibiotics are a much better option than oral antibiotics.