What is prepatellar bursitis (housemaid's knee)?

Updated: Sep 15, 2020
  • Author: Divakara Kedlaya, MBBS; Chief Editor: Dean H Hommer, MD  more...
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Answer

The prepatellar bursa is a superficial bursa with a thin synovial lining located between the skin and the patella. In cadaveric studies, a trilaminar prepatellar bursa was found in 78-93% of people, and a bilaminar bursa was found in 7-22% cases. [1] Normally, the prepatellar bursa does not communicate with the joint space and contains a minimal amount of fluid; when it becomes inflamed, however, there is a marked increase of fluid within its space. It is clinically very important in prepatellar bursitis to differentiate between chronic nonseptic bursitis (NSB) and acute septic bursitis (SB). [2, 3]

Prepatellar bursitis is historically called "housemaid's knee," although it is also known as "coal miner’s knee" [4] and "carpet layer’s knee." [5] In the literature, the earliest reference to the condition and its management occurred in 1861. [6] (See the image below.)

Prepatellar bursa in normal (left) and inflamed (r Prepatellar bursa in normal (left) and inflamed (right) state; trilaminar form.

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