• Anserine Tendinobursitis Syndrome

    (Goosefoot Bursitis; Pes Anserine Bursitis; Anserine Tendonitis)

    Definition

    Anserine tendinobursitis syndrome is a pain to the inner part of the leg, just below the knee joint. It is at a location where three tendons meet and connect to bone. The tendons connect three leg muscles to bone. The muscles include the sartorius, gracilis, and semitendinosus. There are also one or more bursae at this location. A bursa is a fluid-filled sac that decreases friction between bones and muscles.
    When bursae become inflamed it is called bursitis . When tendons become inflamed it is called tendonitis . For this pain syndrome, the exact cause is unknown, but it may involve injury or inflammation to the tendons or bursae.
    Three Tendons Insertion
    medial knee muscle insertion
    Copyright © Nucleus Medical Media, Inc.
    This may be a treatable condition. Contact your doctor if you think you may have this syndrome.

    Causes

    This condition is most commonly caused by repeated stress to the knee. This injury is common among runners. It is also common among people with conditions such as:
    A direct injury to the knee can also cause this condition.

    Risk Factors

    These factors increase your chance of this injury. Tell your doctor if you have any of these risk factors:
    • Runner
    • Osteoarthritis
    • Tear to meniscus
    • Obese
    • Change in running routine
      • More miles
      • Sudden increase in workout
    • Tight hamstrings
    • Flat feet
    • Diabetes
    • Feet that roll inwards (overpronation)

    Symptoms

    If you have any of these symptoms do not assume it is due to this condition. These may be caused by other conditions. Tell your doctor if you have any of these:
    • Pain to inside part of knee
    • Knee tenderness
    • Swelling
    • Pain worsens with bending and straightening of knee
    • Pain worsens with exercise

    Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. You will be asked to show exactly where you feel the pain. Often diagnosis is made by physical exam alone. Sometimes an x-ray is performed to rule out other injuries.

    Treatment

    Talk with your doctor about the best plan for you. Treatment options include the following:

    Rest

    You will be instructed to rest the affected knee until the pain goes away. You may also be advised to ice your knee 3-4 times a day to decrease the inflammation.

    Medications

    Nonsteroidal antiinflammatory drugs (NSAIDs) help with pain and inflammation. Your doctor will advise you which NSAID to take and how often. You may also receive a steroid injection directly into your knee to relieve pain and inflammation.

    Prevention

    To help reduce your chance of developing anserine tendinobursitis, take the following steps:
    • When increasing your workout or run, do so gradually.
    • Stretch before and after your workout.
    • Wear appropriate shoes for the specific activity and your feet.

    RESOURCES

    American Academy of Family Physicians http://www.aafp.org

    AmericanAcademy of Orthopaedic Surgeons http://www.aaos.org

    CANADIAN RESOURCES

    Canadian Orthopaedic Association http://www.coa-aco.org/

    Canadian Orthopaedic Foundation http://www.canorth.org/

    References

    Alvarez-Nemegyei, Jose MD, Canoso JJ. Evidence-Based Soft Tissue Rheumatology IV: Anserine Bursitis. JCR: Journal of Clinical Rheumatology . 10(4):205-206, August 2004.

    Anserine tendinopathy. DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Accessed November 12, 2008.

    Calmbach WL, Hutchens M. Evaluating patients presenting with knee pain: part II differential diagnosis. American Academy of Family Physicians website. Available at: http://www.aafp.org/afp/20030901/917.html . Accessed November 12, 2008.

    Dixit S, Difiori JP, Burton M, Mines B. Management of patellofemoral pain syndrome. American Academy of Family Physicians website. Available at: http://www.aafp.org/afp/20070115/194.html . Accessed November 12, 2008.

    Goosefoot (Pes Anserine) Bursitis of the Knee. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00335 . Accessed November 12, 2008.

    Uson J, Aguado P, Bernad M, et al. Pes anserinus tendino-bursitis: what are we talking about?. Scand J Rheumatol . 2000;29(3):184-6.

    Revision Information

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