Pes anserinus bursitis refers to symptomatic inflammation of the pes anserinus bursa, which is located at the medial aspect of the knee, deep to the pes anserinus tendons.
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Diagnosis
With the correct history of pain, many clinicians will diagnose pes anserinus bursitis based on the presence of increased bursal fluid alone 1.
Clinical presentation
Classically, symptoms are pain and swelling along the proximal medial tibia, which may be exacerbated by particular activities such as ascending and descending stairs 1,3.
Pathology
Pes anserine bursitis can be caused by or associated with 3:
- overuse, especially in runners
- inflammatory arthropathies
- diabetes mellitus
- obesity
- friction from nearby spurs, osteochondromas, etc.
Radiographic features
The anatomic location is the key to making the diagnosis. The actual signs are those of bursitis anywhere else in the body 1.
MRI
- increased bursal fluid
- thickened bursal wall
- surrounding tissue edema
- abnormal wall / surrounding tissue enhancement
Treatment and prognosis
Pes anserine bursitis typically responds well to conservative treatment (rest, analgesia) 3.
Differential diagnosis
medial tibial crest friction syndrome (MTCFS): soft tissue and bone marrow edema anterosuperior to the location of pes anserine bursa 2
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