Injection or aspiration in prepatellar bursitis

Pre-patella Bursitis/Housemaid's Knee

Based on contributions from Dr Elspeth Wise and Dr Alan Walker on behalf of the Primary Care Rheumatology and Musculoskeletal Medicine Society

Pre-patella Bursitis presents with localized erythema and swelling

• generally associated with friction at the site and can be caused by infection, gout/pseudo gout and can be associated with Rheumatoid Arthritis
  
  
• aspiration should be performed in cases of suspected infection but otherwise this is generally treated conservatively with advice to try to avoid any aggravating/precipitating activities
  
  
• corticosteroid injections are generally avoided due to lack of supporting evidence and the risk of adverse events.

To aspirate the bursa, the patient rests on a couch with their knee supported in extension.

A needle is inserted at a suitable point and the contents of the bursa removed.

Bursae of the knee:

Open Image in Modal

Bursitis of the knee video - different types of bursitis

Reference:

• Primary Care Rheumatology Society (PCRS). Joint and soft tissue Injection guidelines PCRS (Updated 2017)