Bursitis over the kneecap

The prepatellar bursa sits between the kneecap and skin. It helps the skin glide when the knee bends, but repeated kneeling, a direct knock, crystal inflammation or infection can make it fill with extra fluid.

The swelling usually forms a defined mound directly over the kneecap rather than filling the whole knee. Bending may feel tight, yet the joint can sometimes move reasonably well because the fluid lies outside the main joint cavity.

A major injury, arthritis or bleeding can also swell the knee. Warmth and redness are especially relevant because a superficial bursa can become infected through a small skin break. Examination helps determine whether fluid is in the bursa, within the joint or in both places.

Stop kneeling and protect the area from further pressure. When kneeling must resume, use well-fitting knee pads and take regular position changes. A cloth-wrapped cold pack and comfortable movement may help control soreness and stiffness.

Do not drain the lump yourself because puncturing the skin can introduce bacteria. A clinician may recommend anti-inflammatory medication after checking whether it is safe for you. Joint aspiration can clarify the cause or relieve a tense bursa in selected cases; fluid may be tested when infection or crystals are suspected.

Obtain prompt medical care when the skin is hot or increasingly red, a wound or drainage is present, or fever and chills occur. Those findings can accompany infected prepatellar bursitis and should not be managed as simple pressure irritation.

Urgent assessment is also appropriate after a forceful injury if you cannot bear weight, cannot straighten the knee, notice deformity, or the swelling expands quickly. Arrange a routine review when the lump persists, repeatedly returns or restricts work and daily activities.

Ask whether the swelling is limited to the prepatellar bursa, whether fluid testing would alter treatment, and how long to avoid kneeling. Discuss protective equipment for work or sport and the benefits and risks of drainage or injection in your situation.