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Arthritis Treatment: "Your Knee Pain Is Not Arthritis, It’s Bursitis"
Knee pain is one of the most common problems encountered in the clinical practice of both rheumatologists and orthopedic surgeons.
While common problems associated with knee injuries are easy to recognize—a player who sustains a serious injury on the field and needs to be assisted—diagnosing non-traumatic knee pain is more difficult.
This article will focus on bursitis (B) which is a common cause of knee pain.
B Inflammation of the bursa, a small sac of fluid that cushions the joint. There are many bursae around the knee joint. When they become irritated or traumatized, they can cause swelling, redness, heat, and pain.
Some common types of B are:
Anserine B. is a type of B that is common in middle-aged, obese people who also have osteoarthritis of the knee. The pain is felt on the inside of the knee approximately two inches below the joint line. Difficulty walking and climbing stairs. Because it is a frequent companion to osteoarthritis of the knee, it is often missed or overlooked.
Treatment includes local remedies such as topical anti-inflammatory medications, ice, physical therapy, and sometimes steroid injections. Steroid injections should be administered using ultrasound guidance.
Prepatellar B Patella- affects the bursa in front of the knee. It is mainly related to pressure and is seen in people who are too bent over due to their occupation. Examples would be plumbers, electricians and carpet layers. Horticulturalists are also at risk. The key point is to rule out infection as it can be a medical emergency. Infected bursae must be treated with antibiotics.
An infrapatellar B is a B that affects the bursa below the knee cap. This is also seen in people who kneel as a result of their work. Traumatic injuries can also be a cause. Infection must also be excluded in patients with infrapatellar B.
A suprapatellar B is a B that affects the bursa above the knee cap. It is relatively uncommon but may occasionally be seen in patients with rheumatoid arthritis.
Most types of B will respond to conservative measures such as ice, rest, physical therapy, knee pads, and non-steroidal anti-inflammatory drugs. Some patients require steroid injections using ultrasound guidance.
Important points to emphasize are that B is a different condition from arthritis and it is imperative to rule out infection before starting treatment.
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