Pes anserine bursitis
Revision as of 08:17, 4 April 2012 by Rossdonaldson1 (talk | contribs)
Background
- Name comes from proximity to the pes anserine (three tendons that insert on the tibia)
- Commonly seen in obese women w/ OA, in runners, and in pts w/ overuse syndrome
Clinical Features
- Anterior medial pain
- Focal swelling may be noted over the bursa
- TTP over the bursa
Treatment
- NSAIDs, rest, heat
- Admit for IV abx if infected bursa is suspected
See Also
Source
- Tintinalli
Background
- Also known as Pes Anserine Bursitis
- Inflammatory condition of the medial knee
- Insertion of sartorius muscle
Risk Factors
- Arthritis of knee
- Obese females
- History of athletic activity (chronic use)
Diagnosis
- Pain, frequently chronic
- Tenderness over the medial knee (insertion of pes anserine)
- Worse with ascending stairs and when arising from a seated position
- Local swelling (occasionally)
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
- Follow up PMD +/- Physical Therapy