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Age / Sex : 41 / M
Age / Sex : 41/M
Chief complaint : Recurred, tender, and
palpable abnormality in anterior aspect of the knee, Yellowish fluid was
aspirated.
1) What is your impression?
Two weeks later, you can see the final diagnosis with a brief discussion of
this case.
* Send Application Answers to In Sook Lee, MD (lis@pusan.ac.kr)
Courtesy : Min
Jeong Seo, Seoul Veterans Hospital
Diagnosis: Prepatellar bursitis
Discussion
Findings:
*** MRI was performed after fluid aspiration
from the palpable abnormality.
Partially
collapsed, oval cystic lesion anterior to the proximal patellar tendon is
noted. It follows fluid signal intensity on all pulse sequences. After
gadolinium injection, enhancing peripheral lining is demonstrated. There is
also subcutaneous edema surrounding the lesion.
Differential Diagnosis: None.
On the basis
of the location, the radiologic impression is prepatellar bursitis.
Diagnosis:
Prepatellar bursitis.
Discussion:
Several bursae are
present around the anterior knee; prepatellar bursa, deep infrapatellar bursa,
superficial infrapatellar bursa.
Prepatellar bursa
is located anterior to inferior pole of the patella and proximal patellar
tendon.
Bursal fluid may
result from local irritation or trauma or as a response to systemic
rheumatologic conditions or infection.
Most
common clinical presentation is anterior knee pain with or without mass.
MRI
examination shows soft tissue swelling or focal fluid collection in this area.
Treatment includes rest, cold therapy, aspiration
of fluid and cortisone injections. Surgery to remove the bursa may be dome as a
last resort.
References:
1. Resnick et al; Bone and Joint Imaging 3rd edition
2.
David W.
Stoller; Magnetic Resonance Imaging in
Orthopaedics and Sports Medicine 3rd edition;
3. Kaplan et al; Musculoskeletal MRI
4. Stoller et al; 2004; Diagnostic imaging: Orthopaedics.
Amirsys.
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