Why does it occur?

Bursa are fluid-filled sacs that serve as a lubricant layer to allow tissue to slide past each other without much friction.  The “pes anserine” literally means “goose foot” because anatomically it resembles the shape of a goose’s foot. The Pes bursa is located on the inner aspect of the knee and lies between the Tibia bone and the tendons of three muscles (sartorius, gracilis, semitendinosus).  Pes bursitis refers to inflammation of this bursa, and is most commonly seen in runners who overtrain, but also more common in runners with poor form, obese patients and patients with a knock-knee deformity (valgus knees).

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Symptoms:

Pes Bursitis typically presents as pain along the inner aspect of the knee. Pain is typically worsened by running and direct pressure on the area. It is often mistaken for a medial meniscus tear. 

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Diagnostic Testing:

An x-ray is usually recommended to evaluate the knee for arthritis and rule out any bony pathology.  An MRI may be ordered to rule out a medial meniscus tear, MCL tear, or other internal knee derangement.

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Treatment Options:

Nonoperative management is the mainstay of treatment for Pes bursitis.  Activity modification is key, while Physical Therapy can be helpful and will usually be recommended.  Those who choose to continue running and participating in other activities that cause them pain will usually not improve.  NSAIDs such as Advil or Aleve (if not contraindicated for the patient) may be considered to decrease pain and swelling. Cortisone injections may also be offered to patients with significant pain or who do not improve from nonoperative treatments.  It is extremely rare for surgery to be necessary for the treatment of Pes Bursitus as long as the treatment recommendations are adhered to.

 

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*It is important to note that all of the information above is not specific to anyone and is subject to change based on many different factors including but not limited to individual patient, diagnosis, and treatment specific variables. It is provided as an educational service and is not intended to serve as medical advice.  Anyone seeking specific orthopedic advice or assistance should consult Dr. Steven Lee or an orthopedic specialist of your choice.

 

*Dr. Steven Lee is a board certified orthopedic surgeon and is double fellowship trained in the areas of Hand and Upper Extremity Surgery, and Sports Medicine. He has offices in New York City, Scarsdale, and Westbury Long Island.