Differential Diagnosis for Prepatellar Bursitis versus Gout
- Single Most Likely Diagnosis
- Prepatellar bursitis: This is the most likely diagnosis given the location of the pain and swelling, which is typically in front of the kneecap (patella). Prepatellar bursitis, also known as housemaid's knee, is an inflammation of the prepatellar bursa, usually caused by repetitive kneeling or direct trauma to the knee.
- Other Likely Diagnoses
- Gout: Gout is a form of inflammatory arthritis characterized by sudden, severe attacks of pain, swelling, redness, and tenderness in one or more joints, most often in the big toe, but it can also occur in the knee. The presentation of gout can sometimes mimic prepatellar bursitis, especially if the knee is involved.
- Septic arthritis: Although less common, septic arthritis (infection within the joint) can present with similar symptoms of pain, swelling, and redness, and it's crucial to differentiate it from other causes due to its need for urgent treatment.
- Do Not Miss Diagnoses
- Septic bursitis: An infection of the bursa, which can present similarly to prepatellar bursitis but requires prompt antibiotic treatment to prevent serious complications.
- Cellulitis or abscess: Infections of the skin and soft tissues that can occur around the knee and may mimic or complicate prepatellar bursitis or gout.
- Deep vein thrombosis (DVT): Although DVT typically presents with swelling and pain in the calf, in some cases, it can occur in the thigh and might be considered in the differential diagnosis of knee swelling and pain, especially if there are risk factors for DVT.
- Rare Diagnoses
- Rheumatoid arthritis: While not typically presenting with isolated knee involvement initially, rheumatoid arthritis can cause knee swelling and pain and should be considered in patients with a history of autoimmune diseases or systemic symptoms.
- Pseudogout (Calcium Pyrophosphate Deposition Disease, CPPD): A type of arthritis that can cause sudden, severe joint pain, similar to gout, but is caused by calcium pyrophosphate dihydrate crystal deposition within the joint.
- Hemarthrosis: Bleeding into the joint space, which can occur due to trauma or bleeding disorders, and might present with sudden onset of knee pain and swelling.