🎙️Deep Dive:Prepatellar Bursitis (Housemaid’s Knee)– MSRA Essentials

Knee pain right overthe front of the patella? Swelling like a little water balloon? In thisepisode, we break down Prepatellar Bursitis,a deceptively simple but clinically important condition — especially for MSRA revision. Whether it’s from kneeling,trauma, or infection, we walk you through whatmatters and why.

🧠Key Concepts Covered

• 📍 Definition: Inflammation of the prepatellar bursa,a fluid-filled sac sitting just in front of the kneecap

• 💥 Causes: Repetitive kneeling (👷‍♂️ carpet layers, cleaners), direct trauma,infection, or associated inflammatory conditions (RA, gout)

• ⚠️Septic vs Non-septic: ~30% are infected – often Staph aureus

• 👩‍⚕️ Risk Factors: Manual occupations, contact sports,immunosuppression, skin breaks

• 🔍 Pathophysiology: Inflammation or bacterial colonisation of the bursa→ swelling, fluid accumulation, tenderness

🔄DifferentialDiagnosis

📌Don't assume it’sbursitis — rule out:

• Septic arthritis – red flag: systemic symptoms,joint pain with all movement

• Patellar tendonitis – pain below the patella

• Meniscal tear – twisting injury,locking/clicking

• Patellofemoral pain syndrome – ache behindkneecap, worse on stairs

• Cellulitis, infrapatellarbursitis, gout/pseudogout

🔬Diagnosis – What YouNeed to Know

✅Aspiration is key – gold standard to rule out infection or crystals

 • Send fluid for:

  – WCC, Gram stain& culture

  – Crystal analysis:

   • ⬆️MSU = gout

   • Rhomboid CPP =pseudogout

✅ Imaging:

 • Not routinely needed unless complicationssuspected

 • 🩻 X-ray: rule out trauma

 • 🧲 MRI/ultrasound: only if persistent or uncertain

💊Treatment Pathways

Type

First-line Management

Second-line

Non-septic

PRICE: rest, ice, NSAIDs, knee pads 🧊

Aspiration ± steroid (if no sepsis)

Septic

Empirical IV antibiotics 🚨

Repeated aspiration or surgical drainage

➡️ Consider bursectomy forchronic/recurrent cases

➡️ Patient education on knee protection is crucialfor prevention 🔁

📈Epidemiology &Prognosis

• 🧍‍♂️ More common in men aged 40–60

• 💼 Linked to manual jobs (e.g. cleaners, roofers, gardeners)

• ~1 in 10,000incidence/year in UK

• 🤒 ~30% are septic – more likely in children or immunocompromised

• 🩹 Non-septic cases usually resolve with conservative care

• 🔁 Recurrence possible if aggravating factors not addressed

📝Rapid MSRA Recap

• Swelling directly over kneecap = think prepatellar bursitis

• Always ask:occupation, trauma, systemic signs

• Aspiration rules in/out: sepsis, gout,inflammation

• Treatment:conservative for non-septic, antibiotics &drainage for septic

• Preventrecurrence: avoid kneeling, use knee pads

📚MSRA Resources forPrepatellar Bursitis

• 🧾 Revision Notes:

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

• 🃏 Flashcards:

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

• ❓Accordion Q&A Notes:

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

• ⏱️Rapid Quiz:

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

• 🔍 Full Quiz:

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

📎For More RevisionSupport

🎓 Full course: https://www.passthemsra.com

🆓 Free resources: https://www.freemsra.com

💡Final Thought

Prepatellar bursitismight seem simple, but missing a septic casecan be serious. Know how to spot it, aspirate safely, and treat it effectively— it's a small joint space, but a big examfavourite.

🔖 #MSRA #PrepatellarBursitis #HousemaidsKnee#MSRARevision #MSRAQuestionBank #MSKRevision #KneePain #MSRAMusculoskeletal#MSRAFlashcards #FreeMSRA #PassTheMSRA #Bursitis