Symptoms

An inflammation of the bursa of the knee can go unnoticed for a long time. Initially, those affected only complain of a slightly rubbing or burning sensation in the knee when walking.As the knee is further strained, the symptoms increase over time and the typical signs of inflammation appear. The knee hurts, is reddened, overheated and swells up.

The pain is often one-sided and occurs mainly when the knee joint is strained. Due to the movement-dependent pain, affected persons often tend to no longer put full weight on the knee and to adopt a relieving position of the affected joint. In rare cases, the inflammation of the bursa can spread to the surrounding tissue and the body.

This can lead to reddening of the leg and to general signs of illness, such as fatigue, fever and swelling of the lymph nodes. It is quite conceivable that bursitis can also occur without pain. A painless course is possible, especially for diabetics, as they often have a neuropathy with a reduced pain sensation. But even in otherwise healthy people, bursitis can be painless at the beginning of the disease, if no sensitive structures of the joint capsule and its surrounding structures have been irritated. Often the pain only begins with the development of an effusion.

Diagnosis

A specific questioning by the physician after physical activities, the occupation, after accidents, injuries or previous illnesses, leads usually already to the searched diagnosis. During the physical examination, swelling, reddening, palpable fluid movements in the knee joint and pain caused by pressure or movement point to a bursitis of the knee. Possibly the surrounding lymph nodes are visibly and palpably enlarged.

If there is suspicion of an underlying disease affecting the joint (e.g. knee arthrosis), imaging procedures such as ultrasound or x-rays of the knee joint can provide indications of pathological joint structures. If it is suspected that a metabolic disorder (e.g. gout) is the cause of bursitis of the knee, the doctor will arrange for a blood test to be performed. Basically, it can be said that abacterial bursitis has a milder course of disease than bacterial bursitis.

If the affected person observes pain, redness and swelling in the knee alone, which are limited to the joint, an abacterial course can be assumed for the first time. Bacterial colonization of the bursa often leads to a scattering of pathogens, which often causes general symptoms such as poor performance and fever in those affected. It is not uncommon for those affected to perceive this as a flu-like infection.

If a small wound on the knee can be identified as the trigger for bursitis, it is important to clarify which pathogens could have possibly entered via the skin defect. Depending on the type of pathogen, typical symptoms can be expected (Staphylokokken→ fever, pus, increased inflammation values in the blood, clostridia → gas gangrene, tetanus). However, medical clarification is always required if symptoms increase in the affected person or last for an unusually long time.