Deep Infrapatellar Bursa

The deep infrapatellar bursa (D) is a V-shaped structure with its apex located between the inferior patellar tendon (PT) and anterior tibial margin. Its crotch opens into a process of the Hoffa fat pad called the fat apron. The bursa may extend laterally beyond the margin of the patellar tendon in 70%-100% of cases and medially to the medial margin of the patellar tendon in up to 45% of cases.

No communication has been reported between this bursa and the articular cavity of the knee. Just anterior to the patellar tendon is another bursa, the superficial infrapatellar bursa (S).

Fluid can be observed in the deep infrapatellar bursa during MR imaging in a variety of conditions, including overuse (e.g., runners and jumpers), ankylosing spondylitis, infection, gout, trauma, and Osgood–Schlatter disease. Between 20%-40% of asymptomatic subjects may also demonstrate fluid in the deep infrapatellar bursa.

Deep infrapatellar bursitis presents clinically as anterior knee pain near the insertion of the patellar tendon

References

Viegas FC, Aguiar RO, Gasparetto E, Marchiori E, Trudell DJ, Haghighi P, Resnick D. Deep and superficial infrapatellar bursae: cadaveric investigation of regional anatomy using magnetic resonance after ultrasound-guided bursography. Skeletal Radiol. 2007 Jan;36(1):41-6.