Housemaid knee is inflammation of: (Repeat)

Ans: A (Prepatellar bursa) Ref: Apley's System of Orthopaedics and Fractures, 9th edition, pg. 578-9 http://en.wikipedia.org/mki/Knee_bursaeExplanation:Housemaid s KneeThis is a friction bursitis of the pre-patellar bursa.The fluctuant swelling is confined to the front of the patella and the joint itself is normal.This is an uninfected bursitis due not to pressure but to constant friction between skin and bone.It is seen mainly in carpet layers, paving workers, floor cleaners and miners who do not use protective knee pads.Treatment consists of firm bandaging, and kneeling is avoided; occasionally aspiration is needed.In chronic cases the lump is best excised.INFRAPATELLAR BURSITIS ('CLERGYMAN'S KNEE')The swelling is below the patella and superficial to the patellar ligament, being more distally placed than prepatellar bursitisTreatment is similar to that for prepatellar bursitis.Occasionally the bursa is affected in gout.Other BursaThe anserine bursa lies between the medial (tihial) collateral ligament and the tendons of the sartorius. gracilis, and semitendinosus (i.e. the pes anserinus).Theoretically, bursitis results from stress to this area (e.g. stress may result when an obese individual with anatomic deformity from arthritis ascends or descends stairs).An occurrence of pcs anserine bursitis commonly is characterized by pain, especially when climbing stairs, tenderness, and local swelling.The suprapatellar bursa or recess between the anterior surface of the lower part of the femur and the deep surface of the quadriceps femoris.It allows for movement of the quadriceps tendon over the distal end of the femur.The suprapatellar bursa extends superiorly from beneath the patella under the quadriceps femoris muscle and its tendon.The bursa is held in place by a small portion of the vastus intermedius muscle called the articularis genus muscle.The suprapatellar bursa may exist as a single bursal sac or, in some patients, as a multiseg- mented series of loculated sacs.The suprapatellar bursa is vulnerable to injury from both acute trauma and repeated microtrauma.Acute injuries may be caused by direct trauma to the bursa during falls onto the knee or patellar fractures.