Knee > Housemaid's Knee

What is Housemaid's Knee?

Housemaid's knee is the common name given to prepatellar bursitis, an inflammation that occurs at the front of the knee, on the kneecap (patella). The term originally referred to maids who developed the injury from spending a lot of time on their knees cleaning floors. Bursitis is an inflammation of the bursae, which are sacks of fluid that help reduce the friction between skin, muscles, tendons, and bone. When the bursa in front of the kneecap becomes irritated, it can swell and become painful.

Repeated pressure on the front of the knee, which can cause irritation and inflammation of the bursa, is the most common cause of housemaid's knee. This can stem from everyday activities like scrubbing floors, laying carpet, or gardening. The bursa can also become inflamed from a direct blow to the kneecap, such as a fall, which can cause bleeding inside the bursa and lead to swelling.

If the bursa has become infected and the infection has not been treated quickly, an abscess, or concentration of pus, may form on the front of the knee. This should be drained with a needle (aspiration) and treated with antibiotics, either orally or intravenously. If the swelling persists, which is a sign that the bursa has thickened, the bursa may have to be removed surgically. In some cases, a normal bursa will grow back after surgery.

There are usually three parts to an orthopedic evaluation: medical history, physical examination, and tests your physician may order.

Your physician will likely ask you to describe your symptoms in detail - the location, duration, and severity of your pain - in order to achieve an accurate diagnosis. Physicians also typically ask about other conditions, such as diabetes and allergies, and medications currently being taken. It is important to describe your symptoms accurately. For example, the degree of pain and when swelling occurs can provide your physician with important clues about the nature of your injury. You also should describe what kind of activities you engage in that could aggravate the condition.

Since the symptoms of housemaid's knee include visible swelling over the kneecap, your physician usually will be able to make an accurate diagnosis by doing a visual inspection and manipulating the area by hand.

TESTS

If a fall or direct blow is the source of the pain on your kneecap, your physician may suggest an X-ray to rule out the possibility of any bone damage. This normally is done in the doctor's office. If an infection is suspected, the bursa will be drained and the fluid will either be analyzed in-house or sent to a hospital laboratory for analysis. Some early results may be available in one to two hours, and final results usually are available in three to five days.

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