pes anserine bursitis

Epidemiology

• more common in overweight women
• frequently occurs in patients with osteoarthritis
• frequently occurs in patients with varus deformities

Clinical manifestations

• history of overuse or change in activity
• stair-climbing may exacerbate symptoms
• tenderness localized along insertion of the sartorius, gracilis, & semitendinosus tendons which overlie the anteromedial tibia inferior to the joint line (knee) ~ 5 cm distal to the medial articular line of the knee
• symptoms exacerbated when knee & hip are flexed to 90 degrees & the femur is internally rotated against resistance
• negative valgus stress test (intact medial collateral ligament)
• symptoms worse with activity & at night

Radiology

• X-ray of knee & tibia (no bony patholgy)

Management

• see bursitis
• eliminate squatting & direct pressure on the anserine bursa
• avoid crossing legs
• limit repititious bending
• apply ice for 15 minutes every 4-7 hours for pain
• glucocorticoid/local anesthetic injection generally brings prompt relief
• NSAIDs may not concentrate well in anserine bursa.
  • NSAIDs, activity modification, & physical therapy treatment of choice

More general terms

• bursitis
• repetitive strain disorder

Additional terms

• pes anserine bursa
• pes anserine pain syndrome