Pes Anserine Bursitis

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Pes Anserine Bursitis

Authors, Editors, Case Information Author: Garry Ho, MD, FAMSSM, FAC Affiliation: OrthoVirginia Co Author(s): None Senior Editor: Carlton Covey, MD, MEd Clinical Vignette: A 48-year-old previously-sedentary male presented with 3 weeks of right anteromedial knee pain with running. On examination of his right knee, there was full ROM, normal ligamentous exam, no joint line tenderness, but positive tenderness to palpation over pes anserinus. Type of Probe Used: 4-12 MHz Linear. Unlabeled Short Axis View of the Pes Anserinus Unlabeled Short Axis View of the Pes Anserinus Labeled Short Axis View of the Pes Anserinus Labeled Short Axis View of the Pes Anserinus with the medial collateral ligament (MCL; M) in long axis. There is a small anechoic collection () deep to the sartorius (S) tendon and superficial of the MCL, consistent with pes anserine bursitis. The gracilis (G) tendon and a branch of the inferior medial genicular nerve (N) are also seen. Unlabeled Long Axis View of the Pes Anserinus Unlabeled Long Axis View of the Pes Anserinus Labeled Long Axis View of the Pes Anserinus Labeled Long Axis View of the Pes Anserinus with the medial collateral ligament (MCL; M) in short axis. There is a small anechoic collection () deep to the sartorius (S) tendon and superficial of the MCL, consistent with pes anserine bursitis. Unlabeled Short Axis View of the Pes Anserine Bursa Injection Unlabeled Short Axis View of the Pes Anserine Bursa Injection Labeled Short Axis View of the Pes Anserine Bursa Injection Labeled Short Axis View of the Pes Anserine Bursa Injection Unlabeled Long Axis View of the Pes Anserine Bursa Injection Unlabeled Long Axis View of the Pes Anserine Bursa Injection Labeled Long Axis View of the Pes Anserine Bursa Injection Labeled Long Axis View of the Pes Anserine Bursa Injection Interpretation Image Interpretation: A small anechoic fluid collection was seen deep to the sartorius tendon and superficial to the MCL, consistent with pes anserine bursitis. Teaching Pearl: The sartorius, gracilis, and semitendinosus tendons insert on the anteromedial proximal tibia to form the pes anserine, distal to the medial joint line. Pes anserine bursitis appears as a small fluid collection deep to these tendons and superficial to the MCL. Medial knee pain can be mislabeled as pes anserine bursitis when the true cause is MCL injury, medial meniscal pathology, osteoarthritis, medial plica syndrome, or patellofemoral pain syndrome. Sonopalpation can help confirm the symptomatic structure as asymptomatic bursal fluid can also be present. References: 1. Curtis BR, Huang BK, Pathria MN, Resnick DL, Smitaman E. Pes anserinus: anatomy and pathology of native and harvested tendons. AJR Am J Roentgenol. 2019;213(5):1107-1116. doi:10.2214/AJR.19.21315 2. Imani F, Rahimzadeh P, Abolhasan Gharehdag F, Faiz SH. Sonoanatomic variation of pes anserine bursa. Korean J Pain. 2013;26(3):249-254. doi:10.3344/kjp.2013.26.3.249 3. Rennie WJ, Saifuddin A. Pes anserine bursitis: incidence in symptomatic knees and clinical presentation. Skeletal Radiol. 2005;34(7):395-398. doi:10.1007/s00256-005-0918-7
NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.

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Authors, Editors, Case Information

Unlabeled Short Axis View of the Pes Anserinus

Labeled Short Axis View of the Pes Anserinus

Unlabeled Long Axis View of the Pes Anserinus

Labeled Long Axis View of the Pes Anserinus

Unlabeled Short Axis View of the Pes Anserine Bursa Injection

Labeled Short Axis View of the Pes Anserine Bursa Injection

Unlabeled Long Axis View of the Pes Anserine Bursa Injection

Labeled Long Axis View of the Pes Anserine Bursa Injection

Interpretation

UPCOMING EVENTS

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