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Anserine Tendinobursitis Syndrome

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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.

Three Tendons Insertion
medial knee muscle insertion
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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

These factors increase your chance of this injury. Tell your doctor if you have any of these risk factors:

  • 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

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.

You may be referred to physicsl 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 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.
  • Follow your doctors directions to manage any underlying conditions

Revision Information

  • Family Doctor—American Academy of Family Physicians

    http://www.familydoctor.org

  • Ortho Info—AmericanAcademy of Orthopaedic Surgeons

    http://www.orthoinfo.org

  • Canadian Orthopaedic Association

    http://www.coa-aco.org

  • Canadian Orthopaedic Foundation

    http://www.canorth.org

  • 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. 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.