Pes anserine bursitis: Difference between revisions
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Revision as of 08:32, 31 January 2015
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
Diagnosis
- 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
DDX
- Hamstring Strain
- Medial Collateral and Lateral Collateral Ligament Injury
- Patellofemoral Syndrome
- Prepatellar Bursitis
- Stress Fracture
- Osteoarthritis
- Myofascial Pain
- Fibromyalgia
Work-UP
- Consider knee x-rays to r/o fx
- Frequently NOT indicated
Treatment
- 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.
- 3-5 mL of 1% lidocaine with or without methylprednisolone into point of maximal tenderness in bursa
Disposition
- Home
- Admit for IV abx if infected bursa is suspected
- Follow up PMD +/- Physical Therapy
See Also
Source
- Tintinalli