Pes anserine bursitis

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Pes anserine bursitis
Pes anserine bursitis
Synonyms	Anserine bursitis, Pes anserinus pain syndrome
Pronounce	N/A
Specialty	Orthopedics, Rheumatology
Symptoms	Knee pain, tenderness on the inner side of the knee
Complications	Chronic pain, reduced mobility
Onset	Gradual
Duration	Can be chronic
Types	N/A
Causes	Overuse, obesity, osteoarthritis, trauma
Risks	Obesity, knee osteoarthritis, female gender, middle-aged
Diagnosis	Physical examination, medical history, imaging
Differential diagnosis	Medial meniscus tear, osteoarthritis, tendinitis
Prevention	N/A
Treatment	Rest, ice, physical therapy, NSAIDs, corticosteroid injections
Medication	Nonsteroidal anti-inflammatory drugs
Prognosis	Good with treatment
Frequency	Common in middle-aged women
Deaths	N/A

Pes anserine bursitis is an inflammatory condition of the bursa located between the tibia and the three tendons of the pes anserinus at the medial aspect of the knee. This condition is often associated with pain and tenderness in the inner knee region, particularly when climbing stairs or engaging in activities that put stress on the knee joint.

Anatomy

The pes anserinus is a conjoined tendon formed by the sartorius, gracilis, and semitendinosus muscles. These muscles insert into the anteromedial surface of the proximal tibia. The pes anserine bursa is a small, fluid-filled sac that reduces friction between the tendons and the tibia. Inflammation of this bursa leads to the condition known as pes anserine bursitis.

Causes

Pes anserine bursitis can be caused by a variety of factors, including:

• Overuse: Repetitive stress from activities such as running, cycling, or stair climbing can irritate the bursa.
• Trauma: Direct trauma to the inner knee can lead to inflammation of the bursa.
• Obesity: Excess weight can increase stress on the knee joint, contributing to bursitis.
• Knee osteoarthritis: Degenerative changes in the knee joint can lead to compensatory movements that irritate the bursa.
• Improper training techniques: Poor form during physical activities can increase the risk of developing bursitis.

Symptoms

Common symptoms of pes anserine bursitis include:

• Pain and tenderness on the inner side of the knee, approximately 2 to 3 inches below the joint line.
• Swelling in the affected area.
• Increased pain with activities such as climbing stairs or getting up from a seated position.
• Stiffness in the knee joint, particularly in the morning or after prolonged sitting.

Diagnosis

Diagnosis of pes anserine bursitis is primarily clinical, based on the patient's history and physical examination. Key diagnostic features include:

• Tenderness over the pes anserine bursa.
• Pain with resisted knee flexion.
• Absence of joint effusion, which helps differentiate it from other knee pathologies.

In some cases, imaging studies such as ultrasound or MRI may be used to confirm the diagnosis or rule out other conditions.

Treatment

Treatment for pes anserine bursitis typically involves conservative measures, including:

• Rest: Avoiding activities that exacerbate symptoms.
• Ice therapy: Applying ice packs to reduce inflammation and pain.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications such as ibuprofen can help reduce pain and swelling.
• Physical therapy: Exercises to strengthen the muscles around the knee and improve flexibility.
• Corticosteroid injections: In some cases, a corticosteroid injection may be administered to reduce inflammation.

Prevention

Preventive measures for pes anserine bursitis include:

• Maintaining a healthy weight to reduce stress on the knees.
• Using proper techniques during physical activities.
• Gradually increasing the intensity of exercise to avoid overuse.
• Wearing appropriate footwear to provide adequate support.

See also

• Bursitis
• Knee pain
• Tendinitis
• Osteoarthritis