Post Traumatic Knee Bursitis

Patient

Q: "Knee pain" was the closest category. I do not have knee pain, but have a build-up of fluid above the lower center of my right knee cap. I fell on the knee 3 months ago - a hard fall, but did not break anything. What's the cause of the fluid build-up and what do I need to do about it?

Doctor

A:    Possibly you are experiencing a post traumatic bursitis, which is an inflammation of the knee bursa caused by repetitive use, trauma, infection, or systemic inflammatory disease, in your case caused by trauma.  Bursae are flattened sacs that serve as a protective buffer between bones and overlapping muscles (deep bursae) or between bones and tendons/skin (superficial bursae). These synovial-lined sacs are filled with minimal amounts of fluid to facilitate movement during muscle contraction. Deep bursae, such as the subacromial (shoulder) and iliopsoas (hip) bursae, are located in the fascia. Superficial bursae, such as the olecranon(elbow) and prepatellar bursae(knee), are located in the subcutaneous tissue. Symptoms of bursitis may or not  include localized tenderness, swelling, redness, and/or reduced /limited movement. Most patients with bursitis are treated conservatively to reduce inflammation. Conservative treatment includes rest, cold and heat treatments, elevation, nonsteroidal anti-inflammatory medication (“Motrin”, “Aleve”), bursal aspiration, and intrabursal steroid injections (with or without local anesthetic agents).

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