Pre-patella Bursitis (Housemaids’ knee)
- More common in carpet layers and miners due to irritation of the pre-patella bursa
- Treatment: Ranges from bandaging and avoidance of kneeling to 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 and the medial head of gastrocnemius
- Usually a painless lump is felt 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 OA)
- Rupture or herniation of the synovium, secondary to increased 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 and capsule, where they multiply
- Months or years later a lump appears or complains of ache
- The lump may appear to be intermittent
- Condition is much more common in the lateral than the medial meniscus
- Lateral meniscus cyst are usually hard and bony, just below the level of the joint line
- Medial meniscus cysts, when occur, are usually larger and softer