ICD-10: M70.42

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 particularly relevant for individuals whose activities involve frequent kneeling or crawling. Below is a detailed overview of the clinical presentation, signs, symptoms, and patient characteristics associated with ICD-10 code M70.42, which specifically denotes prepatellar bursitis of the left knee.

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: Activities that involve prolonged kneeling or crawling.
- Infection: Bacterial infection can lead to septic bursitis.
- Underlying conditions: Conditions such as gout or rheumatoid arthritis may predispose individuals to bursitis.

Patient Characteristics

Patients who typically present with prepatellar bursitis often share certain characteristics:
- Occupation: Commonly seen in individuals in occupations that require frequent kneeling, such as construction workers, carpet layers, and gardeners.
- Age: More prevalent in middle-aged adults, although it can occur in younger individuals engaged in similar activities.
- Gender: While it can affect both genders, it may be more common in males due to occupational exposure.

Signs and Symptoms

Common Symptoms

Patients with prepatellar bursitis may report the following symptoms:
- Localized swelling: A noticeable swelling over the kneecap, which may be soft and fluctuant.
- Pain: Tenderness and pain at the front of the knee, particularly when kneeling or bending the knee.
- Limited range of motion: Discomfort may lead to reduced mobility in the knee joint.
- Warmth and redness: In cases of infection, the area may appear red and feel warm to the touch.

Physical Examination Findings

During a physical examination, healthcare providers may observe:
- Swelling: Prominent swelling over the prepatellar bursa.
- Tenderness: Increased tenderness upon palpation of the bursa.
- Range of motion: Pain during flexion and extension of the knee, particularly when pressure is applied to the bursa.

Additional Signs

In cases where bursitis is caused by infection, additional signs may include:
- Fever: Systemic symptoms such as fever may be present.
- Pus or discharge: If the bursa is infected, there may be drainage of pus.

Conclusion

Prepatellar bursitis (ICD-10 code M70.42) is characterized by inflammation of the bursa in front of the kneecap, primarily affecting individuals engaged in activities that involve frequent kneeling. The clinical presentation typically includes localized swelling, pain, and tenderness, with potential limitations in knee mobility. Understanding the signs and symptoms, along with patient characteristics, is crucial for accurate diagnosis and effective management of this condition. If you suspect prepatellar bursitis, it is advisable to seek medical evaluation for appropriate treatment options, which may include rest, ice, anti-inflammatory medications, or, in some cases, aspiration or corticosteroid injections.

Prepatellar bursitis, specifically coded as M70.42 in the ICD-10-CM system, 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. Below are alternative names and related terms that can be associated with this diagnosis.

Alternative Names for Prepatellar Bursitis

1. Housemaid's Knee: This colloquial term refers to prepatellar bursitis, particularly in individuals who frequently kneel, such as housemaids or carpet layers.
2. Kneeling Bursitis: A descriptive term that highlights the common cause of the condition related to prolonged kneeling.
3. Anterior Knee Bursitis: This term emphasizes the location of the bursitis at the front of the knee.
4. Patellar Bursitis: A more general term that can 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, not just the knee.
2. Knee Pain: While not specific to bursitis, knee pain is a common symptom associated with this condition.
3. Knee Inflammation: This term encompasses various inflammatory conditions affecting the knee, including bursitis.
4. Tendonitis: Often confused with bursitis, tendonitis refers to inflammation of the tendons around the knee, which can occur concurrently with bursitis.
5. Synovitis: Inflammation of the synovial membrane in the knee joint, which may accompany bursitis.
6. Chondromalacia Patellae: A condition that involves softening of the cartilage on the underside of the kneecap, which can be related to or confused with bursitis.

Clinical Context

Understanding these alternative names and related terms is crucial for healthcare professionals when diagnosing and coding conditions accurately. It also aids in patient education, as patients may refer to their condition using different terminology. Proper identification of prepatellar bursitis can lead to more effective treatment strategies, including rest, physical therapy, and in some cases, corticosteroid injections to reduce inflammation.

In summary, prepatellar bursitis (M70.42) is known by several alternative names and is related to various terms that describe knee-related conditions. Recognizing these can enhance communication among healthcare providers and improve patient understanding of their diagnosis.

Prepatellar bursitis, commonly referred to as "housemaid's knee," is an inflammation of the bursa located in front of the kneecap (patella). The ICD-10-CM code for prepatellar bursitis of the left knee is M70.42. Diagnosing this condition involves a combination of clinical evaluation, patient history, and sometimes imaging studies. Below are the key criteria used for diagnosis:

Clinical Evaluation

1. Patient History

• Symptoms: Patients typically report localized pain and swelling in the front of the knee. Symptoms may worsen with activities that involve kneeling or prolonged sitting.
• Duration: The duration of symptoms is assessed, as acute bursitis may present differently than chronic cases.
• Activity Level: A history of repetitive kneeling or trauma to the knee can be significant, especially in occupations or activities that require such movements.

2. Physical Examination

• Inspection: The knee is examined for swelling, redness, and warmth over the bursa. A visible bulge may be present in cases of significant swelling.
• Palpation: Tenderness is typically noted when palpating the area over the prepatellar bursa. The clinician may also assess for any fluctuation, indicating fluid accumulation.
• Range of Motion: The range of motion of the knee joint is evaluated to determine if pain limits movement.

Diagnostic Imaging

3. Imaging Studies

• Ultrasound: This is often the first imaging modality used to assess bursitis. It can help visualize fluid accumulation in the bursa and assess the extent of inflammation.
• MRI: In more complex cases or when other conditions are suspected, an MRI may be performed to provide detailed images of the knee structures, including the bursa, tendons, and ligaments.

Differential Diagnosis

4. Exclusion of Other Conditions

• It is crucial to differentiate prepatellar bursitis from other knee conditions such as:
  • Patellar tendinitis: Inflammation of the tendon connecting the kneecap to the shinbone.
  • Osteoarthritis: Degenerative joint disease that may cause similar symptoms.
  • Infections: Septic bursitis must be ruled out, especially if there are systemic symptoms like fever.

Laboratory Tests

5. Laboratory Analysis

• In cases where infection is suspected, aspiration of the bursa may be performed, and the fluid analyzed for signs of infection or crystals (indicative of gout or pseudogout).

Conclusion

The diagnosis of prepatellar bursitis (ICD-10 code M70.42) is primarily clinical, relying on a thorough history and physical examination, supported by imaging studies when necessary. Accurate diagnosis is essential for effective management and treatment, which may include rest, ice, compression, elevation (RICE), physical therapy, and in some cases, corticosteroid injections or surgical intervention if conservative measures fail.

Prepatellar bursitis, commonly referred to as "housemaid's knee," is an inflammation of the bursa located in front of the kneecap (patella). The ICD-10 code for this condition is M70.42, specifically indicating prepatellar bursitis of the left knee. Treatment approaches for this condition typically involve a combination of conservative management, physical therapy, and, in some cases, surgical intervention. Below is a detailed overview of standard treatment approaches for prepatellar bursitis.

Conservative Management

1. Rest and Activity Modification

• Rest: Patients are advised to avoid activities that exacerbate knee pain, particularly kneeling or prolonged squatting.
• Activity Modification: Adjusting daily activities to minimize stress on the knee can help reduce inflammation and pain.

2. Ice Therapy

• Cold Compresses: Applying ice packs to the affected area for 15-20 minutes several times a day can help reduce swelling and alleviate pain. This is particularly effective in the initial stages of inflammation.

3. Compression and Elevation

• Compression Bandages: Using elastic bandages or knee sleeves can provide support and reduce swelling.
• Elevation: Keeping the knee elevated above heart level can help decrease swelling.

4. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

• Medications: Over-the-counter NSAIDs such as ibuprofen or naproxen can be used to relieve pain and reduce inflammation. These medications should be taken as directed and under the guidance of a healthcare provider.

Physical Therapy

1. Strengthening Exercises

• Quadriceps and Hamstring Strengthening: A physical therapist may recommend specific exercises to strengthen the muscles around the knee, which can help stabilize the joint and reduce stress on the bursa.

2. Stretching Exercises

• Flexibility Training: Stretching exercises can improve the range of motion and flexibility of the knee, which may help alleviate symptoms.

3. Modalities

• Ultrasound and Electrical Stimulation: These therapeutic modalities may be used by physical therapists to promote healing and reduce pain.

Injections

1. Corticosteroid Injections

• Intra-articular Injections: If conservative treatments fail to provide relief, corticosteroid injections into the bursa may be considered. These injections can significantly reduce inflammation and pain.

2. Hyaluronic Acid Injections

• Viscosupplementation: In some cases, hyaluronic acid injections may be used to lubricate the joint and reduce pain, although this is less common for bursitis specifically.

Surgical Intervention

1. Bursectomy

• Surgical Removal: If conservative treatments and injections do not alleviate symptoms, surgical intervention may be necessary. A bursectomy involves the removal of the inflamed bursa, which can provide significant relief for chronic cases.

2. Arthroscopy

• Minimally Invasive Surgery: In some cases, arthroscopic surgery may be performed to address underlying issues contributing to bursitis, such as loose bodies or cartilage damage.

Conclusion

The treatment of prepatellar bursitis (ICD-10 code M70.42) typically begins with conservative management strategies, including rest, ice therapy, and NSAIDs. If symptoms persist, physical therapy and corticosteroid injections may be considered. In chronic cases where conservative measures fail, surgical options such as bursectomy may be necessary. It is essential for patients to work closely with their healthcare providers to develop a tailored treatment plan that addresses their specific needs and circumstances.

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 particularly relevant in clinical settings, and it is classified under the ICD-10-CM code M70.42, which specifically denotes prepatellar bursitis of the left knee.

Clinical Description

Definition

Prepatellar bursitis occurs when the bursa, a small fluid-filled sac that reduces friction between tissues, becomes inflamed. This inflammation can result from repetitive trauma, prolonged kneeling, or direct impact to the knee, leading to pain and swelling in the affected area.

Symptoms

Patients with prepatellar bursitis typically present with the following symptoms:
- Swelling: Noticeable swelling over the kneecap, which may be soft and fluctuant.
- Pain: Localized pain at the front of the knee, which may worsen with movement or pressure.
- Limited Range of Motion: Difficulty bending or straightening the knee due to discomfort.
- Warmth and Redness: The skin over the bursa may appear warm and red, indicating inflammation.

Causes

The primary causes of prepatellar bursitis include:
- Repetitive Activities: Occupations or activities that involve frequent kneeling or crawling, such as plumbing or gardening.
- Trauma: Direct blows to the knee, such as falls or accidents.
- Infection: In some cases, the bursa may become infected, leading to septic bursitis, which requires immediate medical attention.

Diagnosis

Clinical Evaluation

Diagnosis of prepatellar bursitis typically involves:
- Medical History: A thorough history of symptoms, activities, and any previous knee injuries.
- Physical Examination: Assessment of swelling, tenderness, and range of motion in the knee.
- Imaging Studies: In some cases, ultrasound or MRI may be used to evaluate the extent of inflammation or to rule out other conditions.

ICD-10-CM Code

The specific ICD-10-CM code for prepatellar bursitis of the left knee is M70.42. This code is part of the broader category of bursitis (M70) and is essential for accurate medical billing and coding, ensuring that healthcare providers can document the condition appropriately for treatment and insurance purposes[1][2].

Treatment

Conservative Management

Initial treatment for prepatellar bursitis often includes:
- Rest: Avoiding activities that exacerbate symptoms.
- Ice Therapy: Applying ice packs to reduce swelling and pain.
- Compression: Using elastic bandages to provide support and minimize swelling.
- Elevation: Keeping the knee elevated to reduce swelling.

Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed to alleviate pain and inflammation. In cases of infection, antibiotics may be necessary.

Physical Therapy

Physical therapy can help strengthen the muscles around the knee and improve flexibility, which may prevent recurrence.

Surgical Intervention

In persistent cases that do not respond to conservative treatment, surgical options such as bursectomy (removal of the bursa) may be considered.

Conclusion

Prepatellar bursitis, particularly when affecting the left knee, is a common condition that can significantly impact daily activities. Understanding the clinical presentation, diagnostic criteria, and treatment options is crucial for effective management. The ICD-10-CM code M70.42 serves as an important tool for healthcare providers in documenting and billing for this condition, ensuring that patients receive appropriate care tailored to their needs.

For further information or specific case inquiries, consulting with a healthcare professional is recommended.