There is a squishy lump on the front of my kneecap. What is it?

How it differs from swelling inside the knee

With swelling inside the joint, the whole knee looks fuller, the dimples beside the kneecap disappear, and bending feels tight. Prepatellar bursitis is different: the lump sits on the front of the kneecap like a small cushion, you can often move it slightly under the skin, and the knee usually still bends reasonably well, although kneeling directly on it hurts.

The bursa is a thin sac that lets the skin glide over the kneecap. Pressure and friction make it fill with fluid. In Qatar it is common among people who kneel for long periods at work, such as tilers, mechanics and cleaners, and it can follow a fall onto the knee. Frequent kneeling and sujood on a hard floor can contribute, especially when combined with kneeling at work.

What you can do

• Avoid kneeling on that knee; use a soft kneeling pad or a cushioned prayer mat
• If kneeling is painful during prayer, praying seated on a chair is an accepted option while the knee settles
• Apply ice for 15 to 20 minutes a few times a day
• Simple anti-inflammatory or pain relief medicine may help if it suits you
• Do not try to squeeze or drain it yourself

Many non-infected cases settle over a few weeks once the pressure stops.

Signs it may be infected

• The lump becomes red, hot and increasingly painful
• There is a cut, graze or insect bite over it
• Redness spreads up or down the leg
• You develop a fever or feel unwell

An infected bursa needs to be seen the same day, as it usually needs antibiotics and sometimes drainage. People with diabetes or lowered immunity should be especially careful.

When to see a knee specialist in Doha

Book an assessment if the lump has not settled after two to three weeks, keeps coming back, or you are unsure whether the swelling is inside or outside the joint. Dr. Gelber can usually tell on examination, sometimes with an ultrasound. If needed, fluid can be drawn off with a needle and tested. Surgery to remove the bursa is rarely needed and is reserved for swelling that keeps returning despite other measures.