🎧Deep Dive:Infrapatellar Bursitis (Clergyman’s Knee)

Welcome back to The Deep Dive, your go-to MSRA revisioncompanion. In this high-yield episode, we unpack InfrapatellarBursitis, sometimes known as Clergyman’sKnee, helping you master the key facts for your MSK section prep —without the fluff.

Whether you’retackling SBA questions or consolidating core knowledge, this episode willsharpen your understanding of what sets infrapatellarbursitis apart from other knee pathologies.

🦴What Is InfrapatellarBursitis?

• Inflammation of the infrapatellar bursa, located below the kneecap
• Acts as a cushion to reduce friction in the anterior knee
• Key symptom: pain and swelling just below the patella

💥Causes & RiskFactors

🔁Repetitive kneeling (e.g. gardeners, plumbers, carpet layers)

⚽️Direct trauma to the front of the knee

🦠Septic bursitis from bacterial infection

🧬Underlyinginflammatory conditions like gout or RA

🛠️ Immunocompromised individuals are at increasedrisk of septic bursitis

📍Mnemonic for Causes:

“Knocks, Kneels & Nasties”

• Knocks = trauma

• Kneels =repetitive pressure

• Nasties =infection/inflammation

📋Symptoms and ClinicalFeatures

• Localised anterior knee pain, worse withkneeling, stairs, or bending

• Swelling and tenderness below the patella

• Pain on palpationover the bursa

• May feel boggy or fluctuant swelling

• In septic cases: redness, warmth, systemic features like fever

🔎DifferentialDiagnoses

• Prepatellar bursitis (above the patella)

• Patellar tendonitis

• Patellofemoral pain syndrome

• Knee osteoarthritis

📍Location is key: Infra = below the kneecap

🧪Investigations

✅ Often a clinical diagnosis

🖼️X-ray or MRI may be used to exclude fracture or tendonpathology

💉Aspiration of thebursa if septic bursitis is suspected (for culture and microscopy)

🧊Management (UKApproach)

💡Mnemonic: B-RICE +NSAIDs

• Bursitis-specific care

• Rest

• Ice

• Compression (if needed)

• Elevation

• NSAIDs for inflammation and pain

💊Antibiotics for septic bursitis

🩺Aspiration ±corticosteroid injection in resistantcases

🔪Surgery = rare, only for chronic/recurrent or severeinfections

📈Prognosis

✅ Most cases resolve within a few weeks

⚠️ Chronic pain or limited mobility if not treatedearly

🚨 Septic bursitis = serious → needs urgentantibiotics to prevent joint damage

🧠Top Tip for MSRA

Always distinguish infrapatellar vs prepatellarbursitis — it’s a common SBA trap!

And if there’s systemic illness, redness, or rapid swelling,think septic bursitis and act fast.

🧪Quick Summary

• Definition: Inflammation of the bursa below the kneecap

• Causes: Kneeling, trauma, infection, orsystemic inflammation

• Symptoms: Pain + swelling just under thepatella

• Diagnosis: Clinical ± aspiration for infection

• Treatment: Rest, NSAIDs, ice, physio —antibiotics if septic

• Complications: Chronic bursitis, infection,mobility loss

📚MSRA Resources

📝 Revision Notes:

https://www.passthemsra.com/topic/infrapatellar-bursitis-revision-notes/

🃏 Flashcards:

https://www.passthemsra.com/topic/infrapatellar-bursitis-flashcards/

📚 Accordion Q&A Notes:

https://www.passthemsra.com/topic/infrapatellar-bursitis-accordion-qa-notes/

🎯 Rapid Quiz:

https://www.passthemsra.com/topic/infrapatellar-bursitis-rapid-quiz/

💡 Quiz Portal:

https://www.passthemsra.com/quizzes/infrapatellar-bursitis/

🌐More Free MSRA Help

• https://www.passthemsra.com

• https://www.freemsra.com

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