Infrapatellar Bursitis

Right below the kneecap, at the front of the knee, just below the infrapatellar bursa, there is pain and swelling.

Infrapatellar bursitis, often known as Clergyman's Knee, happens when one of the tiny fluid-filled sacs in the knee becomes inflamed and irritated.

Bursa are tiny sacs or pockets filled with fluid that are located between bones, muscles, and tendons. They offer lubrication and cushioning, enabling the soft tissues to glide over bone without causing any friction.

Actually, there are two sacs that make up the infrapatellar bursa:

Between the patellar tendon and the skin that lies above it is the Superficial Infrapatellar Bursa.

Patellar tendon and shin bone(tibia) are connected by a bursa called the deep infrapatellar bursa.

The superficial and deep infrapatellar bursae are regarded as a single entity for all practical purposes.

When you bend and straighten your knee, the infrapatellar bursa shields the patellar tendon, allowing it to slide along the tibia with ease.

Bursitis is the result of the bursa producing too much fluid as a defense mechanism against injury as a result of irritation, pressure, or friction. The bursa swells gradually, and if ignored, it could thicken and harden. In severe cases, the bursa may develop calcifications.

Causes of Infrapatellar Bursitis

Kneeling or crawling frequently: When you are on your knees, extra pressure squeezes the infrapatellar bursa. The bursa eventually thickens and enlarges as a result.

Running, jumping, kicking, climbing stairs, and other activities that demand repetitive knee bending put a lot of friction on the bursa, causing it to enlarge.

An abrupt, forceful hit to the front of the knee might cause the infrapatellar bursa to be immediately damaged, or it can lead to bleeding and extra fluid surrounding the knee that seeps into the bursa and makes it enlarge.

Knee Conditions: Jumpers knee (patellar tendonitis), Osgood Schlatters disease, and infrapatellar bursitis are the two most frequent knee conditions that can lead to infrapatellar bursitis.

Septic bursitis arises from an infection brought on by bacteria that enter the infrapatellar bursa through a skin wound.

Infrapatellar Bursitis Symptoms

The following symptoms of infrapatellar bursitis typically appear gradually over several weeks or months:

Swelling: Infrapatellar bursitis frequently causes swelling at the front of the knee. Just below the kneecap, there could be a squashy pocket of fluid that is painful to the touch towards the front of the shin.

Knee Pain: Infrapatellar bursitis typically causes pain to be felt at the front of the knee, directly beneath the kneecap. It could even go all the way down the front of the shin. The discomfort from infrapatellar bursitis usually grows worse when bending the knee or going up and down stairs. Kneeling will hurt a lot since it will crush the bursa.

Redness and Warmth: The skin on the front of the knee, especially if it has septic infrapatellar bursitis, may be warm to the touch.

Bursitis can make it difficult to fall asleep and keep you awake at night because it causes pain when you bend your knee or turn over.

Knee Stiffness & Weakening: Because clergyman's knee hurts, you could use your knee less frequently. Over time, this could result in joint stiffness and weakness.

Treatment of Infrapatellar Bursitis 

• Rest: Steer clear of sports and workouts that stress your knee. It takes time for the bursa to recover. Resting will prevent the infrapatellar bursa from becoming irritated and inflamed and will hasten the healing process.
• Keep Pressure Off: Try to avoid kneeling or crawling altogether to relieve as much pressure from your knee as you can. Wear knee guards or kneel on a cushion if you must stoop. And if going up and down stairs hurts, it can actually help to make some minor adjustments to your technique.
• Applying ice to the front of the knee on a regular basis will help to lessen the discomfort and swelling brought on by infrapatellar bursitis.
• Non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed by your doctor to help with bursitis pain and swelling reduction.
• Aspiration: Using a needle and syringe, your doctor can aspirate extra fluid from the infrapatellar bursa. To further minimize discomfort and swelling, they could also administer corticosteroids into the bursa at the same time.
• Physical therapy: To regain complete strength, mobility, and function in the knee with infrapatellar bursitis, strengthening exercises and stretches are crucial.
• Surgery: Your doctor may recommend surgery to entirely remove the bursa if symptoms do not improve despite medication; however, this is often only done as a last resort.

Differential Diagnosis

Other medical disorders that produce front knee pain and have symptoms similar to infrapatellar bursitis exist. If the front of the knee is not swollen, another issue could be present, such as:

• Jumpers Knee: the patellar tendon itself is inflamed.
• Osgood Schlatters: damage to the bone where the patellar tendon inserts. Typical in kids after a growth spurt
• Prepatellar Bursitis: bursitis in the bursa that is immediately in front of the kneecap
• Runners Knee: an issue with the kneecap's motion
• Chondromalacia Patella: The cartilage that lines the rear of the kneecap has been damaged.
• Plica Syndrome: inflammation of the knee joint's lining

Ref.

knee-pain-explained.com