Ultrasound-Guided Cortisone for Prepatellar Bursitis

 

Introduction

Prepatellar bursitis is a condition that affects the front of the knee, causing swelling, tenderness, and functional discomfort. It occurs when the prepatellar bursa, a small fluid-filled sac located in front of the kneecap (patella), becomes inflamed or irritated.

At Alton Pain Clinic, our clinicians offer thorough assessments and structured treatment plans for conditions such as prepatellar bursitis. Among the interventional options available is the use of ultrasound-guided cortisone injections, allowing precise targeting of the affected bursa. This blog explores prepatellar bursitis in detail, from anatomy and pathology to diagnosis and management, while also explaining the role of cortisone and its mechanism of action.

Anatomy of the Prepatellar Bursa

The knee joint contains several bursae, which act as cushions between bone and soft tissue.

  • Prepatellar Bursa: Positioned in front of the patella, between the skin and the kneecap.
  • Its main role is to reduce friction during knee movement, particularly when kneeling or bending.

Being located close to the surface, the prepatellar bursa is especially vulnerable to irritation from pressure or direct impact.

Pathology of Prepatellar Bursitis

Prepatellar bursitis develops when the bursa becomes inflamed and accumulates excess fluid.

Common causes include:

  • Repetitive kneeling for work or sport (e.g. tiling, plumbing, gardening)
  • Direct trauma to the knee.
  • Infection spreading into the bursa.
  • Underlying conditions such as gout or rheumatoid arthritis.

The inflamed bursa often results in swelling, warmth, and discomfort at the front of the knee.

Risk Factors

Several factors can make individuals more susceptible:

  • Occupations requiring prolonged kneeling.
  • Contact sports or repetitive activity.
  • Previous knee trauma.
  • Systemic inflammatory conditions.

Symptoms and Clinical Features

Key symptoms include:

  • Swelling and visible enlargement at the front of the knee.
  • Pain or tenderness over the kneecap.
  • Redness and warmth if infection is present.
  • Difficulty kneeling, squatting, or climbing stairs.
  • Reduced mobility due to swelling.

Diagnosis

Accurate diagnosis is made through clinical examination and imaging.

  • Clinical Assessment: The swelling over the kneecap is often obvious on inspection.
  • Ultrasound: Provides clear imaging of the bursa and confirms fluid collection.
  • Aspiration: May be performed if infection is suspected, allowing analysis of the fluid.

Management of Prepatellar Bursitis

Management depends on the underlying cause and severity.

Conservative Measures

  • Resting the knee and avoiding kneeling.
  • Use of non-steroidal anti-inflammatory medication.
  • Knee pads or cushioning for prevention in certain occupations.

Interventional Measures

When conservative treatment is insufficient, ultrasound-guided cortisone injections can be used as part of a structured management plan.

Role of Ultrasound Guidance

At Alton Pain Clinic, ultrasound is an essential tool for accurate treatment. It enables clinicians to:

  • Visualise the prepatellar bursa in real-time.
  • Guide the needle precisely into the inflamed sac.
  • Avoid damage to nearby tissues.
  • Ensure targeted delivery of cortisone.

Cortisone and Its Mechanism of Action

Cortisone is a corticosteroid commonly used in musculoskeletal conditions.

Mechanism of action:

  • Reduces the release of inflammatory chemicals.
  • Minimises fluid build-up and swelling.
  • Modulates the local immune response.
  • Reduces nociceptive signalling, lowering the perception of discomfort.

By addressing the inflammatory process, cortisone injections help improve comfort and function when carefully applied to the affected bursa.

Why Choose Alton Pain Clinic

Choosing Alton Pain Clinic offers:

  • Expert Clinicians with experience in musculoskeletal interventions.
  • Precision with ultrasound-guided procedures.
  • Tailored Care Plans designed to suit individual needs.
  • Comprehensive Support alongside interventional options.

Conclusion

Prepatellar bursitis is a common source of discomfort at the front of the knee, often linked to kneeling, trauma, or systemic conditions. Careful diagnosis and tailored management are essential in restoring knee comfort and function.

At Alton Pain Clinic, ultrasound-guided cortisone injections are available as part of a broader approach to managing prepatellar bursitis. With a focus on precision and patient-centred care, we provide support to help individuals move forward with greater ease.

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