Question
A 42-year-old man comes to the physician for 1 month of worsening right knee pain. He has not had any trauma other than stubbing his toe 3 days ago at the garage where he works as a mechanic. Examination of the right knee shows swelling and erythema with fluctuance over the inferior patella. There is tenderness on palpation of the patella but no joint line tenderness or warmth. The range of flexion is limited because of the pain. Which of the following is the most likely underlying cause of this patient’s symptoms?
| A. |
Noninflammatory degeneration of the joint
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| B. |
Infection of the joint
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| C. |
Deposition of crystals in the joint
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| D. |
Inflammation of periarticular fluid-filled sac
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Show Answer
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Correct Answer � D
Explanation
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Answer D) Inflammation of periarticular fluid-filled sac
This condition commonly occurs in individuals with occupations that require excessive kneeling.
Inflammation of periarticular fluid-filled sac
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Prepatellar bursitis is an inflammation of the synovial bursa located between the skin and patella.
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It is often caused by overuse injuries or repeated trauma to the knee.
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Professions which require frequent kneeling (e.g., carpet installers, masons, plumbers, mechanics) are especially prone to developing prepatellar bursitis.
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The condition most often manifests with localized swelling, tenderness on palpation and with range of motion, and a palpable fluid collection (the inflamed bursa), all of which are observed in this patient; fever, warmth, or spreading erythema are characteristically absent.
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Surgery may be indicated (e.g., drainage of pus, bursectomy) for recurrent bursitis if conservative management fails.
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