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Prepatellar Bursitis (Housemaid’s knee)
Housemaid’s knee is caused by inflammation of the bursa (a small fluid-filled sac) in front of the kneecap. It more commonly occurs in people who spend long periods of time kneeling and treatment is usually supportive only and the outlook is generally very good.
The bursa is a small sac of fluid and has a thin lining. The function of a bursa is to help reduce friction and allow maximal range of motion around joints. When there is inflammation within a bursa (bursitis), the bursa swells due to an increase in the amount of fluid within the bursa sac.
There are four bursae located around the knee joint, all of which are prone to inflammation. However, the prepatellar bursa (the bursa in between the skin and the kneecap) is most commonly affected. Another condition is Clergyman’s knee; inflammation to the infrapatellar busae and this can be superficial or deep. The superficial infrapatellar bursa is located between the tibial tubercle and the overlying skin, whereas the deep infrapatellar bursa is located between the posterior aspect of the patellar tendon and the tibia.
There are a number of different things that can cause housemaid’s knee:
A sudden injury to the knee
Re-current minor injury to the knee. This usually happens after spending long periods of time kneeling down, putting pressure on the kneecap (patella). Historically, this was typical of housemaids who spent long periods of time on their knees scrubbing floors; hence, the term housemaid’s knee.
A co-existing inflammatory disease such as synovitis related to rheumatoid arthritis.