Prepatellar And Pes Anserine Bursitis

The term ''bursa'' is Latin for ''pouch'' and is a synovium-lined sac that helps lubricate structures that move along one another. Bursae facilitate motion by reducing friction, and they can become symptomatic when inflamed, damaged, or infected. Prepatellar and pes anserine bursitis are commonly encountered causes of anterior knee pain.

The prepatellar bursa is a superficial bursa located between the skin and the anterior patella. Inflammation of this structure, also known as ''Housemaid's knee,'' results in prepatellar bursitis and is a common cause of AKP in those individuals who frequently kneel or spend large amounts of time on their knees

Box 2: Grading of Chondromalacia Patella (modified Shahriaree) [60]

Grade 1. Arthroscopic findings: Softening of articular cartilage; T1-weighted MR findings: Partial width focal decreased signal areas of patellar cartilage on T1-weighted sequences, not extending to cartilage surface.

Grade 2. Arthroscopic findings: "Blistering" of articular cartilage with surface abnormality; T1-weighted MR findings: Focal area of sharply marginated decreased signal extending to the articular surface.

Grade 3. Arthroscopic findings: Cartilage fibrillation; T1-weighted MR findings: Indistinct focal areas of decreased signal extending to the articular surface.

Grade 4. Arthroscopic findings: Full thickness cartilage ulceration; T1 weighted MR fingings: Full-thickness decreased signal abnormalities with associated subchondral bone low signal changes.

Patellofemoral Osteoarthritis
Fig. 6. Patellofemoral osteoarthritis. Radiograph demonstrates osteophytes at the PF articulation.

such as gardeners and carpet layers. Radiography may show prepatellar soft tissue swelling. Symptoms and physical exam findings may include pain that increases with ambulation or kneeling, decreased range of motion, and erythema/edema along the lower pole of the patella. MRI will usually show a pre-patellar fluid collection with low T1/high T2 signal.

Pes anserine bursitis is an inflammation of the conjoined insertion of the sar-torius, gracilis, and semitendinosus muscle tendons along the proximal medial aspect of the tibia [24]. This entity is commonly associated with degenerative joint disease of the knee, but can also be seen in younger, active individuals who engage in sports requiring frequent side-to-side movements. The most specific physical exam finding is pain over the proximal anterior medial tibia where the conjoined tendons insert. On T1WI, there is usually a low intensity fluid collection in the region of the pes anserinus along the medial tibial meta-physis, which shows relatively high homogeneous signal on T2WI (Fig. 7).

Prepatellar Bursitis
Fig. 7. (A,B) Prepatellar bursitis. T2-weighted images demonstrates fluid signal intensity superficial to the patellar tendon, consistent with prepatellar bursitis.
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Responses

  • MARI
    When bursitis of the knee is also a stress fracture?
    6 years ago
  • Frederick
    Is the pes anserine knee bursa considered prepatellar?
    5 years ago
  • Marie
    What is low grade pes anserine bursitis?
    1 year ago
  • lillo
    Is it bursitis, tendonitis, or stress fracture?
    7 months ago

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