Knee bursitis is an inflammatory condition which can affect various parts of the knee joint. Most cases involved swelling of the bursa located either below or above the kneecap on the top side of the knee. Like all forms of bursitis, misdiagnosis is common, especially when visual inflammation is minimal or nonexistent. Remember, degeneration of the joint is normal and expected, yet pain from joint deterioration is not typical.
Knee pain has a tendency of being a chronic or recurrent condition, despite active treatment. Many patients undergo surgery and feel immediate relief, only to suffer a re-injury or flare-up of pain in a few months or years later. This may support the theory that a great number of cases of knee issues are non-structurally motivated and part of a larger mindbody symptom imperative.
This essay explores alternative explanations for pain that is often mistakenly diagnosed as being caused by bursa degeneration and inflammation in the knee joint.
The two most common forms of bursa inflammation in the knee joint include:
Prepatellar bursitis is a more common and visually frightening inflammation above the knee cap often characterized by a large red and inflamed mass on the front of the knee. In this condition, diagnosis is usually spot-on, since the evidence is so obvious.
Infrapatellar bursitis inflammation below the knee cap which is often not visualized to the naked eye. This form of bursitis is far more misdiagnosed in the knee joint, due to the various other common pain syndromes which could also be involved in the causative process.
The knees are one of the anatomical locations which suffer from a wide range of diagnosed pain syndromes. Knee pain can be a very debilitating condition and the various diagnoses of osteoarthritis, meniscus tears and various soft tissue pathologies, such as iliotibial band syndrome, are rampant in the musculoskeletal treatment community.
In my experience, the knee is also a common site of tension myoneural syndrome and other manifestations of mindbody pain.
Knee symptoms are especially common in runners and serious athletes. This may be due to the physical demands placed on the joint during training and competition or may also be related to the mindbody stresses associated with the activity.
Arthroscopic knee surgery has become a huge business with physicians performing so many procedures in both number and scope.
For prepatellar bursitis, the diagnostic certainty is much better than for other types of bursa inflammation in the knee.
In some cases, however, even this seemingly obvious condition is misdiagnosed, since similar symptomatic profiles can be produced by rheumatoid arthritis and other autoimmune conditions. In these cases, even though there is obvious anatomical inflammation, the true underlying source may still be a mindbody syndrome or a systemic disease process.
Just remember that the knee joint is very sensitive and once the structural integrity is compromised through surgery, many patients never fully recover 100% usage. Always treat knee issues conservatively, unless there is no other option.
I can not even begin to tell you how many patients I have corresponded with who underwent arthroscopic surgery and ended up worse off for their trouble. In fact, my neighbor is going through it right now, all for arthritic changes which were completely normal and not even indicated reasons for surgery. I should mention that I had an MRI-confirmed torn meniscus twice in my right knee and never underwent any reparative surgery. The knee is still fine and functional, many years later.