Pes anserine bursitis: Difference between revisions
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===Background=== | ===Background=== | ||
*Name comes from proximity to the pes anserine (three tendons that insert on the tibia) | *Name comes from proximity to the pes anserine (three tendons that insert on the tibia) | ||
*Inflammatory condition of the medial knee | *Inflammatory condition of the medial knee | ||
===Risk Factors=== | ===Risk Factors=== | ||
# | #Osteoarthritis of knee | ||
#Obese females | #Obese females | ||
#History of athletic activity ( | #History of athletic activity (overuse) | ||
##E.g. runners | |||
==Diagnosis== | ==Diagnosis== | ||
# | #Anterior medial knee pain, frequently chronic (insertion of pes anserine) | ||
##Worse with ascending stairs and when arising from a seated position | ##Worse with ascending stairs and when arising from a seated position | ||
# | #Focal swelling occasionally noted over the bursa | ||
#TTP over the bursa | |||
==DDX== | ==DDX== | ||
| Line 60: | Line 39: | ||
==Disposition== | ==Disposition== | ||
#Home | #Home | ||
##Admit for IV abx if infected bursa is suspected | |||
#Follow up PMD +/- Physical Therapy | #Follow up PMD +/- Physical Therapy | ||
==See Also== | |||
*[[Knee (Minor)]] | |||
==Source== | |||
*Tintinalli | |||
[[Category:Ortho]] | [[Category:Ortho]] | ||
Revision as of 08:22, 4 April 2012
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
- Myofascial Pain
- Osteoarthritis
- Patellofemoral Syndrome
- Prepatellar Bursitis
- Stress Fracture
- 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