What is the pathophysiology of bursitis of knee?

Updated: Dec 11, 2020
  • Author: Kristine M Lohr, MD, MS; Chief Editor: Herbert S Diamond, MD  more...
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Answer

The medial collateral ligament bursa is most commonly injured secondary to a twisting injury with external tibial rotation. Medial joint line pain occurs and may limit knee extension. This may be confused with a meniscal tear on physical examination.

Anserine (pes anserinus) bursitis is not usually associated with overuse but may occur in patients with medial compartmental osteoarthritis. Clinically, patients complain of pain and tenderness over the anteromedial knee that is worse with knee flexion. This condition may be confused with medial meniscal pathology. [18, 19]

Prepatellar bursitis, also known as housemaid’s knee, is associated with trauma or with repetitive kneeling over an extended period. The prepatellar bursa is also a common site for septic (infectious) bursitis, a diagnosis that should be considered when there is skin injury, erythema, warmth, or severe tenderness over the patella. In patients with septic prepatellar bursitis, the patella is not palpable, and knee flexion is painful.

Popliteal bursae (Baker cysts) are associated with local swelling and pain on walking, jumping, and squatting. Magnetic resonance imaging (MRI) or ultrasonography can differentiate an isolated bursitis from intra-articular injury. (See also Baker Cyst.)


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