Pes anserine bursitis: Difference between revisions
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===Risk Factors=== | ===Risk Factors=== | ||
*Osteoarthritis of knee | |||
*Obese females | |||
*History of athletic activity (overuse) | |||
**e.g. runners | |||
== | ==Clinical Features== | ||
*Anterior medial knee pain, frequently chronic (insertion of pes anserine) | |||
*Worse with ascending stairs and when arising from a seated position | |||
*Focal swelling occasionally noted over the bursa | |||
*TTP over the bursa | |||
== | ==Differential Diagnosis== | ||
{{Knee DDX}} | |||
== | ==Evaluation== | ||
*Consider knee x-rays to | *Consider knee x-rays to rule out fracture | ||
**Frequently NOT indicated | **Frequently NOT indicated. See [[Ottawa Knee Rules]] | ||
== | ==Management== | ||
*RICE | |||
*[[NSAIDS]] | |||
*Physical Therapy | |||
*Intrabursal injection with local anesthetics and/or corticosteroids (second line treatment) | |||
**3-5 mL of 1% [[lidocaine]] with or without [[methylprednisolone]] into point of maximal tenderness in bursa | |||
**Do not inject actual tendons themselves. | |||
==Disposition== | ==Disposition== | ||
*Home | |||
*Admit for IV antibiotics if [[septic bursitis|infected bursa]] is suspected | |||
*Follow up with primary care provider +/- Physical Therapy | |||
==See Also== | ==See Also== | ||
*[[Knee | *[[Knee diagnoses]] | ||
== | ==References== | ||
<references/> | |||
[[Category: | |||
[[Category:Orthopedics]] | |||
[[Category:Sports Medicine]] | |||
Revision as of 21:45, 21 May 2020
Background
- Name comes from proximity to the pes anserine (three tendons that insert on the tibia)
- Inflammatory condition of the medial knee
Risk Factors
- Osteoarthritis of knee
- Obese females
- History of athletic activity (overuse)
- e.g. runners
Clinical Features
- Anterior medial knee pain, frequently chronic (insertion of pes anserine)
- Worse with ascending stairs and when arising from a seated position
- Focal swelling occasionally noted over the bursa
- TTP over the bursa
Differential Diagnosis
Knee diagnoses
Acute knee injury
- Knee dislocation
- Knee fractures
- Meniscus and ligament knee injuries
- Patella dislocation
- Patellar tendonitis
- Patellar tendon rupture
- Quadriceps tendon rupture
Nontraumatic/Subacute
- Arthritis
- Gout and Pseudogout
- Osgood-Schlatter disease
- Patellofemoral syndrome (Runner's Knee)
- Patellar tendonitis (Jumper's knee)
- Pes anserine bursitis
- Popliteal cyst (Bakers cyst)
- Prepatellar bursitis (nonseptic)
- Septic bursitis
- Septic joint
- DVT
Evaluation
- Consider knee x-rays to rule out fracture
- Frequently NOT indicated. See Ottawa Knee Rules
Management
- RICE
- NSAIDS
- Physical Therapy
- Intrabursal injection with local anesthetics and/or corticosteroids (second line treatment)
- 3-5 mL of 1% lidocaine with or without methylprednisolone into point of maximal tenderness in bursa
- Do not inject actual tendons themselves.
Disposition
- Home
- Admit for IV antibiotics if infected bursa is suspected
- Follow up with primary care provider +/- Physical Therapy