Pes anserine bursitis

Background

• Name comes from proximity to the pes anserine (three tendons that insert on the tibia)
• Commonly seen in obese women w/ OA, in runners, and in pts w/ overuse syndrome

Clinical Features

• Anterior medial pain
• Focal swelling may be noted over the bursa
• TTP over the bursa

Treatment

• NSAIDs, rest, heat
• Admit for IV abx if infected bursa is suspected

See Also

• Knee (Minor)

Source

• Tintinalli

Background

• Also known as Pes Anserine Bursitis
• Inflammatory condition of the medial knee
  • Insertion of sartorius muscle

Risk Factors

1. Arthritis of knee
2. Obese females
3. History of athletic activity (chronic use)

Diagnosis

1. Pain, frequently chronic
2. Tenderness over the medial knee (insertion of pes anserine)
   1. Worse with ascending stairs and when arising from a seated position
3. Local swelling (occasionally)

DDX

1. Hamstring Strain
2. Medial Collateral and Lateral Collateral Ligament Injury
3. Myofascial Pain
4. Osteoarthritis
5. Patellofemoral Syndrome
6. Prepatellar Bursitis
7. Stress Fracture
8. Fibromyalgia

Work-UP

• Consider knee x-rays to r/o fx
  • Frequently NOT indicated

Treatment

1. RICE
2. NSAIDS
3. Physical Therapy
4. Intrabursal injection with local anesthetics and/or corticosteroids (second line treatment)
   1. 3-5 mL of 1% lidocaine with or without methylprednisolone into point of maximal tenderness in bursa
      1. Do not inject actual tendons themselves.

Disposition

1. Home
2. Follow up PMD +/- Physical Therapy