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# Infrapatellar bursae

The infrapatellar bursae are two small fluid sacs around the patellar tendon, one under the skin and one behind the tendon.

Official name: Subcutaneous infrapatellar bursa

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## What it is

Small fluid sacs around the patellar tendon.

## What it does

Reduce friction around the tendon.

## Key points

- Two bursae: a superficial one under the skin over the tibial tuberosity and a deep one behind the lower patellar ligament; neither normally opens into the knee joint
- The deep bursa is separated from the joint cavity by the infrapatellar fat pad
- Deep infrapatellar bursitis adds to pain at the tibial tuberosity in adolescents with Osgood–Schlatter disease and in adults with patellar tendinopathy

## Key facts

**Where**
Superficial: between skin and tibial tuberosity; deep: between patellar ligament and tibia above tuberosity

**Function**
Reduce friction around patellar ligament; superficial one inflamed by upright kneeling (clergyman's knee)

## Relations

**Superficial**
Superficial bursa: lies under the [skin](https://durgical.com/en/anatomy/skin/) over the tibial tuberosity and the lower [patellar ligament](https://durgical.com/en/anatomy/patellar-ligament/)

**Deep**
Deep bursa: between the back of the lower patellar ligament and the upper front of the [tibia](https://durgical.com/en/anatomy/tibia/), just above the tibial tuberosity

**Above**
[Infrapatellar fat pad](https://durgical.com/en/anatomy/infrapatellar-fat-pad/), which separates the deep bursa from the knee joint cavity

## How to find it

Superficial bursitis is a soft swelling over the tibial tuberosity. Deep bursitis gives tenderness and fullness on both sides of the lower patellar ligament, just above its insertion.

## On imaging

Ultrasound along the patellar ligament often shows a thin film of fluid in the deep bursa as a normal finding; a distended bursa, a thickened ligament or a fragmented tuberosity point to bursitis, tendinopathy or Osgood–Schlatter disease.

## Clinical notes

- The superficial bursa, like the prepatellar one, can become infected through a skin break from kneeling
- Pain over the tibial tuberosity has a short differential: Osgood–Schlatter disease, patellar tendinopathy at its insertion and deep or superficial infrapatellar bursitis
- Superficial infrapatellar bursitis is the classic 'clergyman's knee', from kneeling upright with weight on the tibial tuberosity; prepatellar bursitis, from kneeling leaning forward, is 'housemaid's knee'

## Test yourself

Think of the answer, then tap the question to see it.

## Where do the superficial and deep infrapatellar bursae lie?

Superficial: under the skin over the tibial tuberosity. Deep: between the lower patellar ligament and the upper tibia, above the tuberosity.

## What separates the deep infrapatellar bursa from the knee joint?

The infrapatellar fat pad; neither infrapatellar bursa normally opens into the joint.

## What is the short differential of pain over the tibial tuberosity?

Osgood–Schlatter disease, patellar tendinopathy at its insertion, and deep or superficial infrapatellar bursitis.

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Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
bursa subcutanea infrapatellaris; bursa infrapatellaris profunda TA2 2739

**Official Spanish (DeCS)**
Bolsas infrarrotulianas subcutánea y profunda DeCS D002061

**English (TA2)**
Subcutaneous infrapatellar bursa

**Also called**
bursa infrapatellaris subcutanea

## Related

- [Patellar tendon](https://durgical.com/en/anatomy/patellar-ligament/)

Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=2094&filter=ths_termall&q=Bolsa%20Sinovial); [Anatomy, Skin Bursa](https://www.ncbi.nlm.nih.gov/books/NBK554438/); [Anatomy, Bony Pelvis and Lower Limb, Knee](https://www.ncbi.nlm.nih.gov/books/NBK500017/).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/anatomy/subcutaneous-infrapatellar-bursa/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/subcutaneous-infrapatellar-bursa/