The most common symptom of prepatellar bursitis is swelling at the kneecap. When bursitis is caused by a trauma to the knee, swelling and other symptoms may appear within 24 hours, similar to a bruise. When bursitis is caused by mini-traumas, such as repeated kneeling, symptoms may appear more slowly, over several days or weeks.

Signs of Knee (Prepatellar) Bursitis

Below is a list of knee bursitis symptoms. If symptoms are accompanied by a feeling of illness or a fever, it may be septic bursitis. This type of bursitis involves an infection and requires immediate medical attention.

  • Localized swelling. An inflamed prepatellar bursa swells up with fluid, and this can be felt and seen through the skin. As it progresses, the knee joint can look double in size. The swollen area may seem "squishy" to the touch. There may be a lump under the skin that is the size of a lime or even the size of a grapefruit.
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  • Tenderness and pain. Knee bursitis patients' reported pain and tenderness varies. For some people, the affected knee might feel achy. Others may just feel tenderness when they put pressure on the knee, for example when kneeling or just pressing down on it. Some patients with non-infected (aseptic) knee bursitis report no tenderness or only mild tenderness. Generally, as the prepatellar bursa swells larger and larger, it will become more tender and painful, particularly if the bursa gets squeezed during extreme bending or straightening of the leg.
  • Range of motion. Knee bursitis usually does not limit joint movement, though in more severe cases the swollen bursa may make it difficult to completely straighten or flex the knee.
  • Warmth and redness. The temperature of the skin over the affected knee might be warmer than elsewhere and may be pink or red.
  • Fever and illness. Having a fever or chills or feeling tired or sick, in addition to other bursitis symptoms, can be a sign of septic bursitis. Septic bursitis is a serious condition and patients should seek medical care to ensure the infection does not spread.

Some people with aseptic knee bursitis will have swelling without other symptoms. Tenderness, redness and warmth at the knee, are especially common in septic bursitis.

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Written by J. Dean Cole, MD
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