Which finding is most characteristic of prepatellar bursitis rather than chondromalacia patella?

• A. Swelling and erythema over the anterior knee
• B. Patellofemoral crepitus on patellar compression
• C. Pain with knee flexion
• D. Tenderness at the medial joint line

Answer: (A)

Localized swelling and warmth over the anterior knee point to prepatellar bursitis. The inflamed bursa sits right in front of the patella, so irritation produces a visible, sometimes soft, swelling with erythema directly over the front of the knee. This superficial anterior swelling is not typical of cartilage problems behind the patella.

In contrast, chondromalacia patella (patellofemoral syndrome) is driven by cartilage wear under the patella and usually presents with patellofemoral crepitus or grinding when the patella is compressed, along with pain that is provoked by bending the knee (stairs, squatting). There isn’t a prominent anterior knee swelling with warmth as seen in bursitis.

Pain with knee flexion can occur in many knee conditions, but it’s not the distinguishing feature here. Tenderness at the medial joint line suggests a meniscal issue rather than bursitis or patellofemoral cartilage wear.