Pes anserine bursitis

Pathology

The pes anserinus is the conjoined tendon of the sartorius, gracilis, and semitendinosus muscles inserting into the anteromedial proximal tibia. Its name, meaning "goose's foot," describes its webbed, footlike structure. This tendon lies superficial to the tibial insertion of the medial collateral ligament. Pes anserine bursitis can arise from stress, overuse, obesity, or trauma.

The condition typically presents with medial knee and upper tibial pain, especially when climbing stairs, along with tenderness and local swelling. Sartorius assists in knee and hip flexion, hip abduction, and lateral thigh rotation. Gracialis adducts the hip and flexes and medially rotates the tibia at the knee. Semitendinosus flexes the knee, medially rotates the tibia on the femur when the knee is flexed, and medially rotates the femur when the hip is extended.

Diagnosis

People with this condition often feel pain on the inner side of the knee when going upstairs, standing up from a seat, or sitting with one leg over the other. Swelling may or may not be present. The chance of developing pes anserine bursitis is higher in those who have osteoarthritis.

Some individuals also mention a feeling of weakness or that their knee does not bend or straighten as much as usual. During an exam, the doctor checks for soreness along the inner knee and upper inner shin while the leg is straight, and also feels the inner tendons with the knee bent at a right angle. X-rays or other scans are not typically needed.

Did You Know?

• Rehabilitative exercises for this condition aim to stretch and strengthen the hip abductors, quadriceps, and hamstrings.
• Physical therapy treatments may include therapeutic ultrasound, electrical stimulation, and ice.