ICD-10: M70.41

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 specifically denoted by the ICD-10-CM code M70.41, which indicates prepatellar bursitis of the right knee.

Clinical Description

Definition and Anatomy

The prepatellar bursa is a small, fluid-filled sac that acts as a cushion between the kneecap and the skin. It helps reduce friction during movement. When this bursa becomes inflamed, it can lead to pain, swelling, and limited mobility in the knee.

Causes

Prepatellar bursitis can arise from various factors, including:
- Repetitive Trauma: Activities that involve frequent kneeling or crawling can irritate the bursa, leading to inflammation. This is common in occupations such as plumbing, carpet laying, and construction.
- Injury: A direct blow to the knee can also cause bursitis.
- Infection: In some cases, the bursa can become infected, leading to septic bursitis, which requires immediate medical attention.
- Underlying Conditions: Conditions such as gout or rheumatoid arthritis can predispose individuals to bursitis.

Symptoms

Patients with prepatellar bursitis typically present with:
- Swelling: A noticeable swelling in front of the knee.
- Pain: Tenderness and pain, especially when kneeling or bending the knee.
- Limited Range of Motion: Difficulty in fully extending or flexing 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 of prepatellar bursitis 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 and rule out other conditions.

Treatment

Treatment options for prepatellar bursitis include:
- 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.
- Corticosteroid Injections: In some cases, injections may be used to reduce inflammation.
- Surgery: Rarely, if conservative treatments fail, surgical intervention may be necessary to remove the bursa.

Conclusion

ICD-10 code M70.41 specifically identifies prepatellar bursitis of the right knee, a condition that can significantly impact an individual's quality of life, particularly for those engaged in activities that require frequent kneeling. Early diagnosis and appropriate management are crucial to prevent complications and promote recovery. Understanding the clinical presentation and treatment options can aid healthcare providers in effectively addressing this condition.

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 code M70.41, specifically indicating prepatellar bursitis of the right knee. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is crucial for effective diagnosis and management.

Clinical Presentation

Definition and Etiology

Prepatellar bursitis occurs when the bursa, a small fluid-filled sac that reduces friction between tissues, becomes inflamed. This inflammation can result from various factors, including repetitive trauma, prolonged kneeling, or direct injury to the knee. It can also be associated with underlying conditions such as gout or rheumatoid arthritis[2][4].

Common Patient Characteristics

Patients who typically present with prepatellar bursitis often share certain characteristics:
- Occupation: Individuals in occupations that require frequent kneeling, such as construction workers, carpet layers, or gardeners, are at higher risk[2].
- Age: While it can occur at any age, it is more prevalent in adults, particularly those over 30 years old[4].
- Gender: Males are more frequently affected than females, likely due to occupational exposure[2].

Signs and Symptoms

Key Symptoms

Patients with prepatellar bursitis may report a variety of symptoms, including:
- Swelling: A noticeable swelling over the kneecap is often the most prominent sign. This swelling can be soft and fluctuating, indicating fluid accumulation in the bursa[3][4].
- Pain: Patients typically experience localized pain at the front of the knee, which may worsen with movement or pressure, such as kneeling[2][3].
- Limited Range of Motion: There may be a reduced ability to fully extend or flex the knee due to pain and swelling[4].
- Warmth and Redness: The affected area may feel warm to the touch and appear red, especially if there is an underlying infection[2].

Additional Signs

• Tenderness: The area over the bursa is often tender upon palpation, which can help differentiate it from other knee conditions[3].
• Crepitus: Some patients may experience a grinding sensation when moving the knee, although this is less common[4].

Diagnosis and Evaluation

Clinical Examination

A thorough clinical examination is essential for diagnosing prepatellar bursitis. Healthcare providers typically assess the knee for swelling, tenderness, and range of motion. They may also inquire about the patient's occupational history and any recent activities that could have contributed to the condition[2][3].

Imaging Studies

In some cases, imaging studies such as ultrasound or MRI may be utilized to confirm the diagnosis and rule out other conditions, such as tears in the knee ligaments or meniscus[4].

Conclusion

Prepatellar bursitis (ICD-10 code M70.41) is characterized by inflammation of the bursa in front of the knee, primarily affecting individuals with occupations involving frequent kneeling. The clinical presentation includes swelling, pain, limited range of motion, and tenderness over the knee. Understanding these signs and symptoms, along with patient characteristics, is vital for accurate diagnosis and effective treatment. If you suspect prepatellar bursitis, consulting a healthcare professional for a comprehensive evaluation is recommended.

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). The ICD-10-CM code for this condition is M70.41, specifically indicating prepatellar bursitis of the right knee. Below are alternative names and related terms associated with this condition.

Alternative Names for Prepatellar Bursitis

1. Housemaid's Knee: This term originates from the condition's historical association with housemaids who frequently kneel on hard surfaces, leading to bursitis.
2. Anterior Knee Bursitis: This term emphasizes the location of the bursitis at the front of the knee.
3. Kneeling Bursitis: A descriptive term that highlights the activity often associated with the onset of the condition.
4. Patellar Bursitis: A broader term that may refer to inflammation of the bursa around the patella, including prepatellar bursitis.

Related Terms and Conditions

1. Bursitis: A general term for inflammation of a bursa, which can occur in various locations throughout the body.
2. Knee Bursitis: A term that encompasses bursitis affecting any of the bursae in the knee, including prepatellar, infrapatellar, and suprapatellar bursitis.
3. Infrapatellar Bursitis: Inflammation of the bursa located below the kneecap, which is a different but related condition.
4. Suprapatellar Bursitis: Inflammation of the bursa located above the kneecap, also related to knee bursitis.
5. Chronic Bursitis: Refers to long-standing inflammation of a bursa, which can include prepatellar bursitis if it persists over time.

Clinical Context

Prepatellar bursitis is often caused by repetitive kneeling, trauma, or infection. It can lead to swelling, pain, and limited mobility in the affected knee. Understanding the alternative names and related terms can aid healthcare professionals in diagnosing and treating this condition effectively.

In summary, prepatellar bursitis (M70.41) is known by several alternative names, including housemaid's knee and anterior knee bursitis, and is related to other forms of bursitis affecting the knee. Recognizing these terms can enhance communication among healthcare providers and improve patient understanding of their condition.

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 M70.41, involves several clinical criteria and considerations. Below is a detailed overview of the diagnostic criteria used for this condition.

Clinical Presentation

Symptoms

1. Localized Pain: Patients typically report pain at the front of the knee, which may worsen with activity or pressure.
2. Swelling: There is often noticeable swelling over the kneecap due to fluid accumulation in the bursa.
3. Tenderness: The area may be tender to touch, and patients might experience discomfort when kneeling or bending the knee.
4. Limited Range of Motion: In some cases, the swelling and pain can lead to a reduced range of motion in the knee joint.

History

• Activity Level: A history of repetitive kneeling or direct trauma to the knee can be significant. This includes occupations or activities that involve prolonged kneeling, such as plumbing, gardening, or flooring work.
• Previous Injuries: Any prior knee injuries or surgeries may also be relevant in the assessment.

Physical Examination

Inspection

• Swelling: The clinician will look for swelling over the patella, which is a hallmark sign of prepatellar bursitis.
• Skin Changes: Any redness or warmth over the area may indicate inflammation.

Palpation

• Tenderness: The clinician will palpate the area to assess tenderness and the extent of swelling.
• Fluid Assessment: In some cases, a fluctuant mass may be felt, indicating fluid accumulation in the bursa.

Range of Motion

• The clinician will evaluate the knee's range of motion to determine if the bursitis is affecting mobility.

Diagnostic Imaging

While the diagnosis is primarily clinical, imaging studies may be utilized to confirm the diagnosis or rule out other conditions:

1. Ultrasound: This can help visualize the bursa and assess for fluid accumulation.
2. MRI: In cases where there is uncertainty, an MRI may be performed to evaluate the soft tissues around the knee.

Laboratory Tests

• Aspiration: In some cases, the bursa may be aspirated to analyze the fluid for signs of infection or other underlying conditions. This can help differentiate between septic bursitis and non-infectious bursitis.
• Blood Tests: Although not routinely necessary, blood tests may be conducted to rule out systemic conditions or infections.

Conclusion

The diagnosis of prepatellar bursitis (ICD-10 code M70.41) is primarily based on clinical evaluation, including patient history, physical examination, and, if necessary, imaging studies. The combination of localized pain, swelling, and a history of repetitive trauma or activity is critical in establishing the diagnosis. If you suspect prepatellar bursitis, it is advisable to consult a healthcare professional for a thorough evaluation and appropriate management.

Prepatellar bursitis, commonly referred to as "housemaid's knee," 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. The ICD-10 code for prepatellar bursitis of the right knee is M70.41. Here, we will explore standard treatment approaches for this condition, including conservative management, medical interventions, and surgical options.

Conservative Management

1. Rest and Activity Modification

One of the first steps in treating prepatellar bursitis is to reduce activities that exacerbate the condition. Patients are advised to avoid kneeling or any repetitive movements that put pressure on the knee. Resting the affected knee allows the inflammation to subside.

2. Ice Therapy

Applying ice to the knee can help reduce swelling and alleviate pain. It is recommended to apply ice packs for 15-20 minutes several times a day, especially after activities that may aggravate the condition.

3. Compression and Elevation

Using a compression bandage can help minimize swelling. Elevating the knee above heart level when resting can also assist in reducing inflammation.

4. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Over-the-counter NSAIDs, such as ibuprofen or naproxen, can be effective in managing pain and reducing inflammation. These medications should be taken as directed and are typically recommended for short-term use.

Medical Interventions

1. Corticosteroid Injections

If conservative measures do not provide sufficient relief, corticosteroid injections may be considered. These injections can significantly reduce inflammation and pain in the bursa. However, they are usually limited to a few times a year to avoid potential side effects.

2. Physical Therapy

Physical therapy can be beneficial in strengthening the muscles around the knee and improving flexibility. A physical therapist may design a tailored exercise program that focuses on stretching and strengthening the quadriceps and hamstrings, which can help support the knee joint.

Surgical Options

1. Bursa Aspiration

In cases where the bursa is significantly swollen or if there is a concern about infection, a healthcare provider may perform a bursa aspiration. This procedure involves using a needle to remove excess fluid from the bursa, which can relieve pressure and pain.

2. Surgical Removal of the Bursa

If conservative treatments fail and the bursitis becomes chronic, surgical intervention may be necessary. This procedure, known as bursectomy, involves the removal of the inflamed bursa. It is typically considered a last resort after other treatments have been exhausted.

Conclusion

The treatment of prepatellar bursitis (ICD-10 code M70.41) primarily focuses on conservative management strategies, including rest, ice therapy, and NSAIDs. If these methods are ineffective, medical interventions such as corticosteroid injections or physical therapy may be employed. In persistent cases, surgical options like bursa aspiration or bursectomy may be considered. It is essential for patients to consult with a healthcare professional to determine the most appropriate treatment plan based on the severity of their condition and individual needs.