ICD-10: M70.4

Prepatellar bursitis, classified under the ICD-10 code M70.4, is a condition characterized by inflammation of the bursa located in front of the kneecap (patella). This condition is commonly associated with repetitive kneeling or direct trauma to the knee. Below are alternative names and related terms for prepatellar bursitis.

Alternative Names

1. Housemaid's Knee: This colloquial term arises from the condition's prevalence among individuals who frequently kneel, such as housemaids or carpet layers.
2. Clergyman's Knee: Similar to housemaid's knee, this term refers to the condition in individuals who kneel often during prayer or religious services.
3. Kneecap Bursitis: A more straightforward term that describes the inflammation of the bursa located near the kneecap.
4. Anterior Knee Bursitis: This term emphasizes the location of the bursitis at the front of the knee.

Related Terms

1. Bursitis: A general term for inflammation of a bursa, which can occur in various locations throughout the body.
2. Knee Bursitis: A broader term that encompasses inflammation of any bursa in the knee region, including prepatellar bursitis.
3. Soft Tissue Disorders: Prepatellar bursitis falls under the category of soft tissue disorders, which includes various conditions affecting muscles, tendons, and bursae.
4. M70.4: The specific ICD-10 code for prepatellar bursitis, which is part of the broader classification of soft tissue disorders (M70-M79).

Conclusion

Understanding the alternative names and related terms for prepatellar bursitis can aid in better communication among healthcare professionals and patients. Recognizing these terms is essential for accurate diagnosis and treatment planning, especially in clinical settings where terminology may vary.

Prepatellar bursitis, commonly referred to as "housemaid's knee," is a condition characterized by inflammation of the bursa located in front of the kneecap (patella). This condition is often associated with repetitive kneeling or direct trauma to the knee, leading to swelling, pain, and limited mobility.

Clinical Description

Definition

Prepatellar bursitis is the inflammation of the prepatellar bursa, a small fluid-filled sac that acts as a cushion between the kneecap and the skin. This bursa helps reduce friction during movement, particularly when kneeling or crawling.

Etiology

The primary causes of prepatellar bursitis include:
- Repetitive Trauma: Activities that involve frequent kneeling, such as plumbing, carpet laying, or gardening, can irritate the bursa.
- Direct Injury: A fall or direct blow to the knee can lead to acute inflammation.
- Infection: In some cases, the bursa can become infected, leading to septic bursitis, which requires immediate medical attention.

Symptoms

Patients with prepatellar bursitis typically present with:
- Swelling: Noticeable swelling over the kneecap.
- Pain: Tenderness and pain, especially when kneeling or applying pressure to the knee.
- Limited Range of Motion: Difficulty bending or straightening the knee due to discomfort.
- Warmth and Redness: In cases of infection, the area may appear red and feel warm to the touch.

Diagnosis

Diagnosis is primarily clinical, based on the patient's history and physical examination. Imaging studies, such as ultrasound or MRI, may be utilized to assess the extent of inflammation or to rule out other conditions.

ICD-10 Code Details

Code: M70.4

• ICD-10 Classification: The code M70.4 falls under the category of "Other soft tissue disorders" (M70-M79) in the ICD-10 classification system. Specifically, it denotes "Prepatellar bursitis."
• Usage: This code is used for billing and coding purposes in healthcare settings to document the diagnosis of prepatellar bursitis for insurance claims and medical records.

Treatment

Management of prepatellar bursitis typically includes:
- Rest and Activity Modification: Avoiding activities that exacerbate symptoms.
- Ice Therapy: Applying ice to reduce swelling and pain.
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help alleviate pain and inflammation.
- Physical Therapy: Strengthening and stretching exercises may be recommended to improve knee function.
- Injections: Corticosteroid injections may be considered for persistent symptoms.
- Surgery: In severe cases, surgical intervention may be necessary to remove the bursa.

Conclusion

Prepatellar bursitis is a common condition that can significantly impact daily activities, particularly for individuals engaged in occupations or hobbies that require frequent kneeling. Understanding the clinical presentation, causes, and treatment options is essential for effective management. The ICD-10 code M70.4 serves as a critical tool for healthcare providers in documenting and billing for this condition, ensuring appropriate care and follow-up for affected patients.

Prepatellar bursitis, commonly referred to as "housemaid's knee," is an inflammatory condition affecting the bursa located in front of the kneecap (patella). This condition is classified under the ICD-10-CM code M70.4. Understanding its clinical presentation, signs, symptoms, and patient characteristics is essential for accurate diagnosis and effective management.

Clinical Presentation

Definition and Etiology

Prepatellar bursitis occurs when the prepatellar bursa, a small fluid-filled sac that reduces friction between the knee joint and the skin, becomes inflamed. This inflammation can result from repetitive trauma, prolonged kneeling, or direct injury to the knee. It is often seen in individuals whose occupations or activities involve frequent kneeling, such as carpet layers, plumbers, and gardeners[3][4].

Common Patient Characteristics

Patients with prepatellar bursitis typically share certain characteristics:
- Occupation: Many affected individuals are involved in jobs that require frequent kneeling or crawling.
- Age: While it can occur at any age, it is more prevalent in adults, particularly those over 30 years old.
- Gender: Males are more frequently affected than females, likely due to occupational exposure[3][4].

Signs and Symptoms

Localized Symptoms

Patients with prepatellar bursitis often report the following symptoms:
- Swelling: A noticeable swelling over the kneecap is a hallmark sign, which may vary in size depending on the severity of the inflammation.
- Pain: Patients typically experience pain at the front of the knee, which may worsen with kneeling or bending the knee.
- Tenderness: The area over the bursa is usually tender to touch, and patients may flinch when pressure is applied[3][4].

Functional Limitations

• Reduced Range of Motion: Patients may have difficulty fully extending or flexing the knee due to pain and swelling.
• Difficulty with Activities: Activities that involve kneeling, squatting, or climbing stairs can become challenging, impacting daily life and occupational duties[3][4].

Systemic Symptoms

In some cases, patients may experience mild systemic symptoms, such as:
- Low-grade Fever: This may occur if there is an underlying infection, although septic bursitis is less common.
- General Malaise: Patients might feel generally unwell, particularly if the bursitis is associated with an infection[3][4].

Conclusion

Prepatellar bursitis is characterized by localized swelling, pain, and tenderness over the kneecap, primarily affecting individuals with occupations that involve frequent kneeling. Recognizing the clinical presentation and associated patient characteristics is crucial for healthcare providers to diagnose and manage this condition effectively. Treatment often includes rest, ice application, anti-inflammatory medications, and, in some cases, aspiration of the bursa if swelling is significant. Understanding these aspects can lead to better patient outcomes and a return to normal activities.

Prepatellar bursitis, commonly referred to as "housemaid's knee," is an inflammation of the bursa located in front of the kneecap (patella). The diagnosis of prepatellar bursitis, particularly for the ICD-10 code M70.4, involves several clinical criteria and considerations. Below is a detailed overview of the diagnostic criteria used for this condition.

Clinical Presentation

Symptoms

• Pain and Tenderness: Patients typically report localized pain at the front of the knee, which may worsen with movement or pressure.
• Swelling: There is often noticeable swelling over the kneecap due to fluid accumulation in the bursa.
• Limited Range of Motion: Patients may experience difficulty bending or straightening the knee fully due to pain and swelling.

Physical Examination

• Palpation: A healthcare provider will palpate the area around the knee to assess for tenderness, warmth, and swelling.
• Range of Motion Tests: The clinician may evaluate the knee's range of motion to determine any limitations caused by pain or swelling.

Diagnostic Imaging

Ultrasound

• Fluid Assessment: An ultrasound can help visualize the bursa and confirm the presence of excess fluid, which is indicative of bursitis.

MRI

• Detailed Imaging: In some cases, an MRI may be used to assess the extent of inflammation and rule out other potential knee injuries or conditions.

Exclusion of Other Conditions

Differential Diagnosis

• Ruling Out Other Causes: It is essential to differentiate prepatellar bursitis from other knee conditions such as:
• Patellar tendinitis
• Osteoarthritis
• Septic bursitis (infection)
• Gout or pseudogout

Laboratory Tests

• Infection Indicators: If septic bursitis is suspected, laboratory tests such as a complete blood count (CBC) or bursal fluid analysis may be performed to check for signs of infection.

History and Risk Factors

Occupational and Activity History

• Repetitive Kneeling: A history of activities that involve frequent kneeling or direct trauma to the knee can support the diagnosis, as these are common risk factors for developing prepatellar bursitis.

Medical History

• Previous Injuries: A history of knee injuries or prior episodes of bursitis may also be relevant in the diagnostic process.

Conclusion

The diagnosis of prepatellar bursitis (ICD-10 code M70.4) is primarily based on clinical evaluation, including symptom assessment, physical examination, and imaging studies when necessary. It is crucial for healthcare providers to consider the patient's occupational history and to rule out other potential knee conditions to ensure an accurate diagnosis. If you have further questions or need additional information on this topic, feel free to ask!

Prepatellar bursitis, classified under ICD-10 code M70.4, is an inflammation of the bursa located in front of the kneecap (patella). This condition is often associated with repetitive kneeling or direct trauma to the knee, commonly seen in occupations or activities that require frequent kneeling, such as plumbing or gardening. Understanding the standard treatment approaches for this condition is essential for effective management and recovery.

Treatment Approaches for Prepatellar Bursitis

1. Conservative Management

Rest and Activity Modification

• Rest: The first step in managing prepatellar bursitis is to reduce or eliminate activities that exacerbate the condition. This may involve taking breaks from kneeling or other knee-intensive activities.
• Activity Modification: Adjusting daily activities to minimize knee strain can help alleviate symptoms. For instance, using kneepads or cushions can provide protection during kneeling tasks.

Ice Therapy

• Application of Ice: Applying ice packs to the affected area for 15-20 minutes several times a day can help reduce swelling and pain. Ice therapy is most effective when used immediately after activities that aggravate the condition.

Compression and Elevation

• Compression: Using an elastic bandage or knee sleeve can help control swelling and provide support to the knee.
• Elevation: Keeping the knee elevated above heart level can assist in reducing swelling, especially after prolonged activity.

2. Medications

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

• Pain Relief: Over-the-counter NSAIDs, such as ibuprofen or naproxen, can help reduce pain and inflammation associated with prepatellar bursitis. These medications should be taken as directed and are typically effective for mild to moderate pain.

3. Physical Therapy

Rehabilitation Exercises

• Strengthening and Stretching: A physical therapist may recommend specific exercises to strengthen the muscles around the knee and improve flexibility. This can help prevent future episodes of bursitis.
• Manual Therapy: Techniques such as massage or mobilization may be employed to improve knee function and reduce pain.

4. Injections

Corticosteroid Injections

• Inflammation Reduction: If conservative treatments fail to provide relief, corticosteroid injections into the bursa may be considered. These injections can significantly reduce inflammation and pain, allowing for improved mobility and function.

5. Surgical Intervention

Bursectomy

• Surgical Options: In chronic cases where conservative management and injections do not yield satisfactory results, surgical removal of the bursa (bursectomy) may be necessary. This is typically considered a last resort after all other treatment options have been exhausted.

Conclusion

Prepatellar bursitis can be effectively managed through a combination of conservative treatments, medications, physical therapy, and, in some cases, surgical intervention. Early recognition and appropriate management are crucial to prevent chronic symptoms and ensure a return to normal activities. If symptoms persist despite initial treatment, it is advisable to consult a healthcare professional for further evaluation and tailored management strategies.