Prepatellar knee joint bursitis: symptoms and treatment

Bursitis is a disease in which the periarticular bag inflames. This pathology occurs in the elbow and knee joints. Of all the types of periarticular inflammation, the most common preapatellar bursitis of the knee joint. This disease is common among people actively involved in sports, after injuries.

Prepatellar bursitis: what is it?

In the upper part of the knee joint is a prepatellar periarticular bag (pre-patellar bursa). It is located above the kneecap. Bursa is filled with a liquid that promotes free sliding and protects the joint from excess friction. Inflammation of this bag is called prepatellar bursitis. How is it manifested?

In the International Classification of Diseases ICD-10, prepathel bursitis is listed under the code M70.4. With such a disease, the natural movement of the fluid in the periarticular bag is disturbed. Forms exudate - a fluid released from the blood vessels during inflammation. In the liquid contents can get an infection, which contributes to the inflammatory process.

The immune system begins to fight infection, a large number of lymphocytes are sent to the site of inflammation - the protective cells of the body. The influx of lymph causes edema, which is one of the main symptoms of pre-patellar bursitis of the knee joint. The photo shown above shows how strongly the swelling of the knee can be. Because of the pressure of lymph on the adjacent tissues and the roots of the nerves, there is pain in the knee. Over time, in the joint area, suppuration can form, so bursitis is easier to treat at the beginning of its development.

Why does prepathel bursitis occur?

Most often, the inflammation of the periarticular bag is due to a sharp knee stroke on a hard surface. People with an active lifestyle are at risk of developing prepathel bursitis. But this is not the only cause of inflammation in the intra-articular bag. The following causes of bursitis can be identified:

• Frequent bruises of the knee;
• Crawling and standing on the knees during work (for example, bursitis is common in roofers, parquet floor cleaners, carpet cleaners, plumbers);
• Direct infection in the joint through scratches and wounds;
• Infectious diseases - brucellosis, tuberculosis, gonorrhea, syphilis (these pathologies are complicated by suppuration inside the bursa);
• Metabolic disorders (diabetes, obesity, gout);
• Autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus).

But whatever the cause of the inflammation, signs of bursitis begin to appear after a knee injury. Sometimes it can be a minor bruise, but even a slight injury can trigger the development of inflammation. If a patient has pre-patellar bursitis of the knee joint, the symptoms and treatment will depend on the form of the disease and the presence of the infectious process.

Signs of acute disease

Acute pre-patellar bursitis occurs unexpectedly, the symptoms grow for several days. The disease is characterized by the following manifestations:

• There is a sharp pain in the nasolennoy cup. A person can not rest on his knees, any touch to the area of inflammation causes painful sensations.
• There is a strong edema in the patella area with reddening of the skin.
• Movement in the affected joint is limited.
• The body temperature rises, there is a general malaise.
• The pain increases when the area of inflammation is probed.

Symptoms of chronic disease

In the absence of adequate treatment, acute bursitis becomes chronic. Chronicization of the inflammatory process can occur with prolonged pressure on the knee joint and in elderly people. The clinical signs of inflammation change slightly. Pain, redness and swelling of the knee joint are still present. They become thicker than the bursal wall, because of this the area of the joint can increase in size several times. There is a feeling of lumps inside the patella because of the formation of wrinkles on the wall of the periarticular bag.

Symptoms of purulent bursitis

If an intra-articular bag gets an infection, then there is a suppuration inside the bursa. Symptoms of the disease become much harder.

• The temperature rises sharply, the general well-being of the patient worsens.
• The skin in the joint area becomes hot to the touch, redness is pronounced.
• There is pain and ripple inside the joint.

What are the consequences of bursitis?

Festering prepathel bursitis requires immediate treatment, otherwise the abscess can spread to other tissues or break through independently. This leads to complications:

• If the abscess breaks into a blood vessel, there may be a blood poisoning - sepsis.
• With the spread of inflammation and suppuration on the nearby bone, osteomyelitis can begin.
• If purulent inflammation spreads to surrounding tissues and lymph nodes, phlegmon and lymphadenitis occur.
• Purulent contents can enter the bursa directly into the joint. Then there is a severe form of purulent arthritis.
• Fistulas form on the skin. These are channels with purulent contents that appear after an independent breakthrough of the abscess in the seminary.
• With prolonged pre-patellar bursitis of the knee, the limb can partially lose its motor function.

How bursitis occurs in childhood

Young children are not prone to prepatellar bursitis. Their weight is too small, and when the child falls on his knees, the blow turns out to be insignificant. Children under one year rarely fall ill with infectious bursitis, as every kid has immunity transmitted from his mother. The possible way of bursitis in children is injuries and knee fractures. But the child usually has flexible bones, and fractures quickly grow together. Bursitis can begin in young children only when help with a fracture of the knee was given too late.

But adolescents often get bursitis. Often inflammation of the bursa is observed in boys of pubertal age, who like an active lifestyle and are intensely engaged in sports. Most often this happens after injuries during training. There is another cause of adolescent bursitis. In pubertal period, children grow rapidly. Sometimes the growth of the joints lags behind the overall growth of the body. And then adolescents have problems with joints, including knee joint bursitis.

Diagnosis of the disease

Usually the diagnosis does not present difficulties for the doctor because of the characteristic picture of the disease. Edema and redness in the patella are noticeable even after external examination. However, sometimes it is necessary to distinguish prepathellar bursitis from other diseases and injuries of the joint area: arthrosis, synovitis, osteomyelitis, rupture of the tendon. Then the doctor appoints additional methods of examination:

• X-ray of the knee;
• Ultrasound of the knee joint;
• MRI;
• Puncture bursa for the purpose of exploring joint fluid.

This will help assess the condition of the periarticular bag, the surrounding tissues and bones, in order to make a diagnosis and prescribe the treatment according to the results of the studies.

How to treat non-infectious bursitis?

Treatment of pre-patellar bursitis of non-infectious origin, as a rule, is conservative. Puncture is done only if there is a lot of blood in the bursa after the injury. The need for this procedure should be decided by the attending physician, since there is a small risk of infection.

At the first stage it is necessary to provide peace for the sick limb. The area of the joint is tightly bandaged with a bandage, if necessary, compresses are applied. Pain is prescribed analgesics. With severe pain, "Prednisolone" is injected into the joint bag. Treatment of acute bursitis takes about 7-10 days.

How to treat chronic bursitis of the knee?

In the treatment of prepatellar bursitis of the knee joint, chronic anti-inflammatory non-steroid preparations are prescribed: "Diclofenac", "Naise", "Nimesil", "Ibuprofen".

Apply physiotherapy procedures:

• massage;
• Electrophoresis;
• Exercise therapy;
• Magnetotherapy;
• Ultrasound therapy;
• Laser treatment.

If inflammatory exudate accumulates in the bursa, then puncture is performed.

Treatment of purulent bursitis

If the bursitis is of an infectious origin and the suppuration has already occurred, then drain the cavity. A thick needle is punctured and pumped out the purulent contents. The cavity of the periarticular bag is washed with solutions of antibiotics and antiseptics. After this procedure, the patient's limb shows rest.

Assign a course of antibacterials of a wide spectrum of action. The duration of antibiotic treatment is about 1-3 weeks. Along with antibacterial drugs, the doctor prescribes glucocorticosteroids. If the patient is disturbed by signs of an organism intoxication (headache, nausea, vomiting, temperature), then droppers are placed with solutions of sodium chloride, "Perftoran", "Ringer". After removal of pus, a course of treatment with glucocorticoid drugs and physiotherapy procedures is carried out.

Operation

It is a radical method of operative treatment of pre-patellar bursitis of the knee joint. To make an incision and remove the bursa is necessary in the event that because of severe pain a person loses the ability to walk and serve himself. This means that the walls of the periarticular bag are thickened so that the bursa can no longer allow the joint to slide. After the operation, the patient wears a special fixator on the knee for 3-5 days. Then the doctor prescribes a course of therapeutic physical education. Usually after the operation a person returns to the usual way of life within a month. It is possible to rely on a diseased knee after 2-3 months.

Folk methods of treatment of bursitis

Home treatments can be used in bursitis as an additional therapy. Before using traditional medicine, you should consult your doctor. With bursitis, compresses from vegetables can help. It is useful to alternate compresses from potatoes, beets and cabbage. Vegetables need to be applied to the aching joint at night. On the first night, several cut raw potatoes are laid on the sore spot, covered with food film and bandaged. On the second night you need to repeat the procedure with beetroot, and on the third - with cabbage.

You can add decoction of pine needles, cones and branches to the bath water. All ingredients need to boil 30 minutes in water, and then infuse the broth for 24 hours. The finished extract should be brown. The broth is added to the water and the bath is taken for 20 minutes. It will take about 1.5 liters of extract. When bursitis is useful to use inside a mixture of propolis and butter. It is necessary to mix the components in equal parts. The composition is taken 1 teaspoon 3 times a day. It is better to use a remedy from propolis 1 hour before eating.

How to prevent disease?

To prevent the development of prepatellar bursitis, you must protect your knee from excessive loads and injuries. Especially it concerns those who are actively engaged in sports. Every training session must begin with a warm-up. If during sports activities there is a risk of knee injury, then you need to protect the joint with special devices (knee pads). This will help avoid serious injuries and complications in the form of prepatellar bursitis. In the photo above you can see one of such protective devices for the knee. In case of damage to the skin, it is necessary to treat the wounds and abrasions as soon as possible with disinfectants and apply bandages. This will help prevent infection into the periarticular bag. Only careful attitude to the joints and timely treatment of injuries will help to avoid bursitis.