WHAT is it??

The pes anserine is an area on the inside of your knee, just below the joint, where the muscles are attached to the bone by tendons. 

This area is cushioned by a fluid-filled sac (bursa). Pes anserine bursitis is a condition that happens when the bursa gets swollen and irritated and causes knee pain. This condition commonly presents with localized pain, tenderness, and swelling over the medial aspect of the knee, approximately 2-3 inches below the joint line. 

WHO are at Risk?

 ·       Are a runner.

·       Play sports that involve a lot of running and quick side-to-side movements (cutting).

·       Are an athlete who plays contact sports.

·       Swim using an inward angle of the knee, such as with the breaststroke.

·       Have tight hamstring muscles.

·       Are a woman.

·       Are overweight.

·       Have flat feet.

·       Have diabetes or osteoarthritis. 

 CAUSES

Due to overuse, direct trauma, obesity, or underlying osteoarthritis of the knee joint. It is frequently encountered in middle-aged individuals, particularly those engaged in activities involving repetitive knee flexion and extension, such as running, cycling, or climbing stairs. 

EXAMINATION

Patients typically report pain exacerbated by activities like climbing stairs, rising from a seated position, or performing deep knee bends. Physical examination often reveals localized tenderness, warmth, and swelling over the pes anserine bursa.

 

MIMICS

Other causes of knee pain, such as medial meniscus injury, medial collateral ligament sprain, or osteoarthritis. 

DIAGNOSIS

Ultrasound or magnetic resonance imaging (MRI) to confirm the diagnosis and assess for concurrent knee pathology.  

PREVENTION

·   Warm up andstretch before being active.

·  Cool down andstretch after being active.

·  Give your body time to rest between periods of activity.

·  Use equipment that fits you.

·  Be safe and responsible while being active to avoid falls.

·  Maintain a healthy weight.

·  Maintain physical fitness, including:

o   Strength.

o  Flexibility.

o  Cardiovascularfitness.

o Endurance. 

TREATMENT

Rest, ice therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy focusing on stretching and strengthening exercises, and corticosteroid injections for symptomatic relief. In refractory cases, other interventions like platelet-rich plasma (PRP) injections or surgical bursectomy may be considered.

CONCLUSION

Understanding the pathophysiology, clinical presentation, diagnostic approach, and management options for pes anserine bursitis is essential for medical practitioners to effectively evaluate and treat patients presenting with knee pain.