Pes Anserine Bursitis

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Pes Anserine Bursitis

Authors, Editors, Case Information Author: Garry Ho, MD, FAMSSM, FAC Affiliation: OrthoVirginia Co Author(s): None Senior Editor: Carlton Covey, MD, MEd Clinical Vignette: 48 year-old previously-sedentary male presents with 3 weeks of right anteromedial knee pain with running. On examination of his right knee, there is full ROM, normal ligamentous exam, no joint line tenderness, but positive tenderness to palpation over pes anserine. Type of Probe Used: 4-12 MHz Linear Probe. pes anserinus unlabeled Images of the pes anserinus long-axis (LAX) and short-axis (SAX) to the medial collateral ligament (MCL; M) shows a small anechoic collection () deep to the sartorius (S) tendon and superficial of the MCL, consistent with anserine bursitis. The gracilis (G) tendon and a branch of the inferior medial genicular nerve (N) are also seen. pes anserinus labeled Images of the pes anserinus long-axis (LAX) and short-axis (SAX) to the medial collateral ligament (MCL; M) shows a small anechoic collection () deep to the sartorius (S) tendon and superficial of the MCL, consistent with anserine bursitis. The gracilis (G) tendon and a branch of the inferior medial genicular nerve (N) are also seen. pes needle unlabeled In-plane (IP) and out-of-plane (OOP) needle-guidance (arrows) on SAX and LAX views, respectively, for anserine bursa aspiration and injection. pes needle labeled In-plane (IP) and out-of-plane (OOP) needle-guidance (arrows) on SAX and LAX views, respectively, for anserine bursa aspiration and injection. Interpretation Image Interpretation: A small anechoic fluid collection was seen deep to the sartorius tendon and superficial to the MCL, consistent with pes anserine bursitis. Teaching Pearl: The sartorius, gracilis and semitendinosus tendons insert roughly 5 cm distal to the medial knee joint line forming the pes anserine. These are primary knee flexors and play a secondary role in tibial internal rotation with a resultant protective effect against rotation and valgus stress. Pes anserine pain syndrome is frequently associated with knee osteoarthritis, obesity, and angular deformity of the knee (varus or valgus alignment). Tendinopathy or bursopathy can also occur with activities involving repetitive knee flexion however true bursitis is relatively uncommon. Sports ultrasound provides valuable information to distinguish pes anserine bursitis from other causes of medial knee pain, and allows for precise needle placement for interventional procedures.
NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.

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Authors, Editors, Case Information

pes anserinus unlabeled

pes anserinus labeled

pes needle unlabeled

pes needle labeled

Interpretation

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