Published: 2018-02-24

Primary patellar osteomyelitis presenting as a pre-patellar bursitis in children: a potential diagnostic mistake

Rajib Naskar, Santosh Bindumadhavan, Rishabh Jaiswal, Harshad Argekar


A 14-year-old male presented with pain and swelling of left knee since 15 days with history of non-significant trauma and mild fever. On clinical examination there was raised superficial skin temperature and pre-patellar effusion with positive patellar tap. Haematological investigations show moderate leucocytosis and raised acute phase reactants, with an unremarkable radiography. Under the impression of infective pre-patellar bursitis, patient was posted for arthrotomy, debridement and wound wash. Post-operative broad spectrum antibiotics started. 2 weeks after surgery the swelling reappears, when an advanced imaging was offered which shows osteomyelitic changes in upper pole of patella. After 6 weeks of intravenous antibiotics and conservative management, the lesion was healed leaving no sequel.



Patellar osteomyelitis, Pre-patellar bursitis, Knee swelling, Children

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Ho-Rim C. Patellar osteomyelitis presenting as prepatellar bursitis. Knee. 2007;14(4):333-5.

Evans DK. Osteomyelitis of the patella. J Bone Jt Surg [Br]. 1962;44:319–23.

Kochar VL, Srivastava KK. Unusual lesions of the patella. Int Surg. 1976;61:37–9.

Kankate R, Selvan T. Primary haematogenous osteomyelitis of the patella: a rare cause for anterior knee pain in an adult. Postgraduate Med J. 2000;76(901):707-9.

Moore T. Acute Osteomyelitis of the Patella. Lancet. 1938;1:552.

Roy DR. Osteomyelitis of the patella. Clin Orthop Relat Res. 2001;389:30–4.

Cahill BR. Nontraumatic osteomyelitis of the patella. Clin Orthop Relat Res. 1978;132:177–9.