Introduction
Pes anserine bursitis is an inflammatory condition that affects the medial (inside) knee at the anserine bursa, a submuscular sac located directly below the pes anserine. Stress, repetitive motion injuries, obesity, and damage to the pes anserine can all cause bursitis. Discomfort in the upper tibial area and medial knee, especially when climbing stairs, tenderness, and local swelling are typical symptoms of pes anserine bursitis. When standing up from a chair, descending stairs, or sitting with their legs crossed, patients frequently complain of knee pain in the medial region. There may or may not be swelling at the spot. Patients with osteoarthritis are more likely to develop peroneal bursitis. They occasionally complain of weakness or a limited range of motion.
What Is Pes Anserine Bursitis?
Bursae are tiny, jelly-like sacs found throughout the body, including the shoulder, elbow, hip, knee, and heel joints. They are made up of a little amount of fluid and are placed between bones and soft tissues to act as abrasion-reducing cushions. Bursitis of the pes anserine bursa is an inflammation of the bursa on the inside of the knee between the shinbone (tibia) and three hamstring muscle tendons. It happens when the bursa becomes irritated and produces an excessive amount of fluid, causing it to expand and exert pressure on the surrounding areas of the knee. Pes anserine bursitis of the knee is characterized by pain and tenderness on the inside of the knee, two to three inches below the joint.
What Is the Pathophysiology Associated With Pes Anserine Bursitis?
According to many studies, obese middle-aged women are more likely to develop pes anserine bursitis. Pes anserine pain has a well-established link to diabetes mellitus. Many individuals with established knee osteoarthritis may have inflammatory pes anserine bursae as a result of prior knee issues rather than as the underlying pathology. It is hypothesized that mechanical disarray at the medial knee joint will result in localized irritation to the nearby tendinous structures. Protrusion of the medial meniscus and displacement of the medial collateral ligament are two examples of this. The anserine bursa may then experience similar inflammation.
What Causes Pes Anserine Bursitis?
Overuse, persistent friction, and tension on the bursa are the usual causes of bursitis. Runners are more prone than other athletes to pes anserine bursitis. Those who have knee osteoarthritis are also at risk. Pes anserine bursitis can occur due to a number of reasons, such as:
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Using improper training methods, such as skipping stretches, jogging too many hills, and abruptly increasing mileage.
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Stiff hamstring muscles.
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Having knock knees or duck feet.
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Knee osteoarthritis.
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Playing an activity that calls for repeated knee motions, such as tennis or soccer.
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Improper knee alignment (valgus).
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Excessive weight.
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Excessive knee use.
What Are the Symptoms Associated With Pes Anserine Bursitis?
The vast majority of patients suffering from pes anserine bursitis experience one or more warning signals. These are some possible signs of pes anserinus:
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Knee joint pain progressively increases and feels better after resting.
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Knee discomfort that gets worse after exercising or climbing stairs.
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Experiencing pain two to three inches below the joint on the inside of the knee.
How Is Pes Anserine Bursitis Diagnosed?
The diagnosis of pes anserine bursitis is not aided by imaging. However, simple knee radiographs are typically obtained to look for any underlying bone abnormalities, such as osteoarthritis.
1. Ultrasonography: Joint effusions, among other potential causes of localized edema, may be assessed in conjunction with ultrasonography.
2. Magnetic Resonance Imaging: Magnetic resonance imaging (MRI) can be used to assess knee pathology and rule out other possible diagnoses. In situations of bursitis, magnetic resonance imaging scans can show fluid in the anserine bursa. However, in five percent of asymptomatic knees, fluid has been found. In light of this, its detection in imaging is not diagnostic. Axial imaging sequences have been proven to be crucial for differentiating fluid collections, particularly in Baker's cyst and the semimembranosus bursa. Anatomically near structures to the collateral ligament that has fluid collections, such as bone cysts, meniscal cysts, and bursitis, would make the differential diagnosis more difficult.
3. Aspiration and Fluid Analysis: When carried out aspiration and fluid analysis, the test revealed mononuclear cells or the lack of inflammatory cells and crystals.
What Are the Treatment Modalities Associated With Pes Anserine Bursitis?
There are numerous methods for easing pain and starting the healing process. The following treatments for pes anserinus bursitis are:
1. Medication - NSAIDs, also known as non-steroidal anti-inflammatory medicines, NSAIDs can help with swelling and pain relief.
2. Rest - Stop engaging in activities that cause flare-ups of bursitis.
3. Ice pack - Apply ice to the affected area to reduce swelling three to four times a day.
4. Wedge Insoles - Wedge insoles can assist in positioning the leg in a more advantageous posture if anterior knee pain is brought on by incorrect knee alignment.
5. Tape for Kinesiology - To reduce the symptoms of anterior knee discomfort, the patient can apply kinesiology tape.
6. Physical Treatment - To aid in regaining strength and range of motion, the healthcare professional may suggest ultrasound treatments or stretching exercises.
7. Injection Shots Into the Bursa - To treat symptoms, the medical professional may inject steroid medicines into the bursa.
8. Injections of PRP - PRP (platelet-rich plasma) is extracted from a blood sample. It is used to encourage tissue regeneration and repair.
9. Surgery - Surgery is uncommon but may be necessary for extreme circumstances. Patients undergo surgical removal of their bursa during this process. After this treatment, patients can typically return to their regular routines in three to four weeks.
Conclusion
The condition known as pes anserine bursitis primarily affects the bursa that lies between the sartorius, gracilis, and semitendinosus muscles and their insertion at the proximal medial tibia. The chance of acquiring this condition increases with weight, underlying osteoarthritis, and feminine gender. An X-ray is typically required for the diagnosis of pes anserine bursitis since the symptoms can be mistaken for those of a stress fracture. The signs of a medial meniscus tear may also appear. The majority of the time, non-operative supportive care is used to treat pes anserine bursitis, and steroid injections are saved for those with refractory cases. To know more about this condition, consult a doctor online.
