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Musculoskeletal System ORGAN SYSTEMS

Pes anserine bursitis

Introduction

Pes anserine bursitis or breaststroke knee is an inflammatory condition of medial knee at pes anserine bursa.


Aetiology

  • More common in overweight middle-age females.
  • Common in swimmers

Pathoanatomy

Pes anserinus “goose-foot”:

Conjoined tendons of three muscles that insert onto the anteromedial (front and inside) surface of the proximal tibia.

  • Pes-anserine tendons: Tendons of Sartorius, Gracilis & semitendinosus
  • Innervation:
    • Sartorius: Femoral n.
    • Gracilis: Obturator n.
    • Semitendinosus: Tibial branch of Sciatic n.

Anserine bursa (tibial intertendinous bursa):

Submuscular bursa located deep to the pes anserinus on the anteromedial proximal tibia.


Clinical features

Pain:

Particular with rising from a seated position, going upstairs, or sitting with their legs crossed (semitendinosus, gracilis, and sartorius function in unison in the act of crossing one leg over the other; thus, this motion typically will elicit the pain seen in pes anserine bursitis)

Tenderness & localized swelling below joint line at the medial aspect of knee


Diagnosis

Differential diagnosis

Knee bursitis:

  • Subpatellar
  • Prepatellar (M/C)
  • Infrapatellar
  • Pes Anserine

Management

  • Physiotherapy
  • Pain management
  • Local injection

 

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