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Pre-patella Bursitis (Housemaids’ knee)
- More common in carpet layers & miners due to irritation of the pre-patella bursa
Treatment
- Nonoperative
- bandaging
- avoidance of kneeling
- Operative
- excision of the lump in chronic cases
Infra patella Bursitis (Clergyman’s knee)
- Similar pathology but the swelling is over the patella tendon / tuberosity not the patella itself
Semimembranosus Bursa
- Bursa between the tendon of semimembranosus & the medial head of gastrocnemius
- Usually painless lump behind the knee
- may be confused with a popliteal cyst or aneurism & communicates with the joint (one way flow)
- Need to check for joint pathology
Popliteal cyst (Bakers when in association with Osteoarthritis)
- Rupture or herniation of the synovium & is secondary to ↑ production of synovial fluid due to some intra-articular pathology
- Treat the joint not the cyst
Meniscal cyst
- Probably traumatic in origin, synovial cells get displaced into the vascular region between the meniscus & capsule where they multiply
- Months or years later
- lump or complains of ache
- The lump may appear to be intermittent & the condition is much more common in the lateral than the medial meniscus
- Lateral meniscus
- cyst are usually hard & bony just below the level of the joint line
- Medial meniscus
- cysts when they do occur are usually larger & softer
