Diagnostic Imaging of Chronic Prepatellar Bursitis (Housemaid's Knee): An Elderly Patient Case Report

Prepatellar bursitis, often referred to as "Housemaid's Knee," is an inflammation of the prepatellar bursa, usually caused by repeated trauma or extended periods of kneeling. Diagnosing chronic cases can be particularly challenging, especially in older individuals and when advanced imaging techniques are not advisable. This case report details a 70-year-old man who experienced swelling in the right front of his knee, difficulty walking, and pain when kneeling for six months. A musculoskeletal (MSK) ultrasound showed a clearly defined cystic mass measuring 4.8×2.1 cm located in front of the patella, with internal lobulations and cloudy fluid, indicative of chronic prepatellar bursal effusion. There was no evidence of internal blood flow or solid masses. Additional observations included irregularities and calcifications at the insertion of the suprapatellar tendon, suggesting chronic degenerative changes. The bursal sac was surgically removed, and histopathological analysis confirmed chronic prepatellar bursitis. The patient gradually showed improvement in symptoms and functional recovery after the surgery. This case highlights the value of MSK ultrasound in diagnosing chronic prepatellar bursitis, particularly when other imaging methods are not feasible. Surgical intervention remains an effective treatment for chronic, stubborn cases. Accurate diagnosis depends on a thorough assessment that combines clinical symptoms, ultrasound findings, and histopathological evidence.