Bursitis, Pes Anserine (Pes Anserine Syndrome)

Bursitis, Pes Anserine (Pes Anserine Syndrome) is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • The pes anserinus (“goosefoot”) is the combined insertion of the sartorius, gracilis, and semitendinosus tendons on the anteromedial tibia.
  • There is a bursa that lies under the pes anserinus (between the semitendinosus tendon and the tibial attachment of the medical collateral ligament).
  • Pes anserine tendino-bursitis (PATB) is due to irritation of the bursa and/or tendons in this area.

Epidemiology

Prevalence
One of the most frequent soft tissue pain syndromes in the knee

Etiology and Pathophysiology

PATB is thought to occur due to:

  • Overuse injury
  • Excessive valgus and rotary stresses
  • Mechanical forces and degenerative changes
  • Direct trauma

Risk Factors

  • More common in middle-aged, overweight females
  • Other risk factors include:
    • Pes planus; genu valgum
    • Long-distance/hill running, cycling, swimming (“breaststroker’s knee”)
    • Sports with side-to-side/cutting activity (soccer, basketball, racquet sports)

Commonly Associated Conditions

  • Osteoarthritis (OA)
    • Increased incidence of PATB in patients with symptomatic OA (1)[C]
    • Prevalence of OA and PATB reported as high as 75% (2)[C]
    • Higher grades of OA associated with a thicker pes anserine bursa and larger area of bursitis (3)[C]
  • Medial meniscal tear
  • Type II diabetes

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Basics

Description

  • The pes anserinus (“goosefoot”) is the combined insertion of the sartorius, gracilis, and semitendinosus tendons on the anteromedial tibia.
  • There is a bursa that lies under the pes anserinus (between the semitendinosus tendon and the tibial attachment of the medical collateral ligament).
  • Pes anserine tendino-bursitis (PATB) is due to irritation of the bursa and/or tendons in this area.

Epidemiology

Prevalence
One of the most frequent soft tissue pain syndromes in the knee

Etiology and Pathophysiology

PATB is thought to occur due to:

  • Overuse injury
  • Excessive valgus and rotary stresses
  • Mechanical forces and degenerative changes
  • Direct trauma

Risk Factors

  • More common in middle-aged, overweight females
  • Other risk factors include:
    • Pes planus; genu valgum
    • Long-distance/hill running, cycling, swimming (“breaststroker’s knee”)
    • Sports with side-to-side/cutting activity (soccer, basketball, racquet sports)

Commonly Associated Conditions

  • Osteoarthritis (OA)
    • Increased incidence of PATB in patients with symptomatic OA (1)[C]
    • Prevalence of OA and PATB reported as high as 75% (2)[C]
    • Higher grades of OA associated with a thicker pes anserine bursa and larger area of bursitis (3)[C]
  • Medial meniscal tear
  • Type II diabetes

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