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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 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.
    Tendons Meet and Connect to Bone
    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. A direct injury to the knee can also cause this condition
  • Risk Factors

    Factors that may increase your chance of anserine tendinobursitis syndrome include:
    • You are a runner
    • Osteoarthritis
    • Tear to meniscus
    • Obesity
    • Change in running routine
      • More miles
      • Sudden increase in workout
    • Tight hamstrings
    • Flat feet
    • Genu valgum—knees touching
    • Feet that roll inwards (overpronation)
    • Diabetes
  • Symptoms

    Anserine tendinobursitis syndrome may cause:
    • 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.
    You may be referred to physical therapy.
    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 anserine tendinobursitis:
    • 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
    • Follow your doctors directions to manage any underlying conditions
  • RESOURCES

    Family Doctor—American Academy of Family Physicians http://www.familydoctor.org

    Ortho Info—American Academy of Orthopaedic Surgeons http://www.orthoinfo.org

    CANADIAN RESOURCES

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

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

    References

    Alvarez-Nemegyei, Jose MD, et al. Evidence-based soft tissue rheumatology IV: Anserine bursitis. J Clin Rheumatol. 2004;10(4):205-206.

    Calmbach WL, Hutchens M. Evaluation of patients presenting with knee pain: Part II. Differential diagnosis. Am Fam Physician. 2003;68(5):917-922.

    Dixit S, Difiori JP, et al. Management of patellofemoral pain syndrome. Am Fam Physician. 2007;75(2):194-202.

    Pes anserine bursitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 20, 2012. Accessed December 17, 2014.

    Pes anserine (knee tendon) bursitis. American Academy of Orthopaedic Surgeons Ortho info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00335. Updated March 2014. Accessed December 17, 2014.

    Uson J, Aguado P, et al. Pes anserinus tendino-bursitis: what are we talking about? Scand J Rheumatol. 2000;29(3):184-186.

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