From the Research
Pes anserine bursitis presents with pain and tenderness at the medial aspect of the proximal tibia, approximately 2-4 cm below the knee joint line, and is characterized by localized pain that worsens with activities involving knee flexion and internal rotation. The clinical signs of pes anserine bursitis include point tenderness over the pes anserine bursa, which is located where the conjoined tendons of the sartorius, gracilis, and semitendinosus muscles insert on the anteromedial proximal tibia 1. Some key features of pes anserine bursitis are:
- Localized pain that worsens with activities involving knee flexion and internal rotation, such as climbing stairs, rising from a chair, or getting in and out of a car
- Point tenderness over the pes anserine bursa
- Swelling may be visible or palpable in this area
- Pain often increases with resisted knee flexion or passive external rotation of the tibia
- There may be associated warmth and erythema if inflammation is significant
- Risk factors include obesity, valgus knee deformity, and activities involving repetitive knee flexion
- Patients with osteoarthritis, diabetes mellitus, or those who participate in running sports are particularly susceptible Differential diagnosis should include medial meniscal tears, medial collateral ligament injuries, and medial compartment osteoarthritis, which can be distinguished through careful physical examination and imaging if necessary 2, 3. It is worth noting that the treatment options for pes anserine bursitis have been studied, and local corticosteroid injection has been shown to be more efficient than PRP injection and ESWT for reducing pain and enhancing function 1. Additionally, other studies have found that kinesiotaping, oxygen-ozone injection, and prolotherapy can also be effective in reducing pain and swelling in patients with pes anserine bursitis 4, 2. However, the most recent and highest quality study should be prioritized when making a definitive recommendation, and the clinical signs of pes anserine bursitis should be carefully evaluated to determine the best course of treatment.