UMEM Educational Pearls

Pes Anserinus pain syndrome (formerly pes anserine Bursitis)

Occurs at the bursa of the pes anserinus which overlies the attachment of the 1) Sartorius 2) gracilis and 3) semi-tendinosis tendons. Insertions resemble a Goose’s foot.

An inflammatory condition of the medial knee

Location is 2-3 inches below the knee joint on the medial side

1st layer of medial compartment

https://sportsclinicnq.com.au/wp-content/uploads/2019/01/Screen-Shot-2019-01-30-at-8.55.48-am-300x291.png

 

https://www.dramynrajani.com/wp-content/uploads/2018/05/pes-anserine-bursitis-clinical-test.jpg

 

Patients complain of knee pain just below medial joint line (esp with stairs)

History may include sudden increase in running distance especially with hills (common)

Associated with obesity, tight hamstring muscles and with knee OA

PE:  Tenderness to palpation of the bursa possibly with mild swelling

DDx: MCL tear, medial meniscus injury, medial (knee) compartment arthritis, tibial stress fracture

 

Treatment: Cessation/modification of offending activities, Icing and ice massage, NSAIDs, hamstring stretching and physical therapy. Failure of the above should prompt referral for bursal steroid injection.