(Fig 4-D.03) Septic Prepatellar Bursitis

https://youtu.be/mPLREkZbVzM

https://youtu.be/YiEAI7pISIU

 

 

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📌 Septic Bursitis

✅ Overview and Causes

• Septic bursitis at the anterior knee can be hematogenous but is more often iatrogenic or related to a penetrating injury. 
• The presence of a draining sinus tract, intrabursal gas, or foreign bodies in the bursa suggests infection, but aspiration is recommended whenever infection is suspected .

 

✅ Imaging Findings

• There is usually enhancement of the bursal wall and surrounding tissues following administration of gadolinium-based intravenously administered contrast medium. 
• However, the infected bursal contents typically do not enhance . 
• If there is enhancement of the overlying skin, then accompanying cellulitis is invariably present. Unfortunately, there is a considerable overlap between the imaging findings of septic and nonseptic bursitis .

 

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📌 Chronic Bursitis

• Chronic bursitis sometimes results in dramatic bursal enlargement, producing a large mass that extends well beyond the patellar borders, associated with wall thickening, loculation, and internal debris. 
• This appearance is difficult to distinguish from bursal infection, as both can contain heterogeneous debris and have thickened walls that enhance after contrast material administration .

 

References

1. RadioGraphics 2018; 38:2069–2101
2. Skeletal Radiol (2010) 39:957–971
3. RadioGraphics 2016; 36:1888–1910

 

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