Diagnosing Pes Anserinus Bursitis

What Are The Symptoms Of Pes Anserinus Bursitis?

Typically with pes anserinus bursitis the major feature is pain where the pain experienced is felt on the inside area of the knee. Generally the pain is most noticeable with regard to regular daily activities felt when going up and down stairs and running. The Pes Anserine area on this inside lower knee area will often be tender to touch and regularly is visually swollen and puffy on palpation.
With a pes anserinus bursitis the clinical presentation may include:

• Pain and/or swelling on the inner aspect of the knee situated approximately 2 to 3 inches below the knee joint.
• Pain as well as reduced or painful range of movement, where painful limitation of bending and/or straightening the knee may exist.
• Pain exacerbated with simple daily activities such as climbing, or descending stairs.
• Feelings of a perceived decrease in strength, or general “weakness” around the knee.
• Squatting, pivoting, kicking and quick side to side movements may also cause discomfort in athletic situations.
• Associated gait changes where the individual may feel the need to limp as a result of the above discomfort, movement or strength changes.

Diagnosis Of A Knee Bursitis

The symptoms of pes anserinus bursitis may mimic those of other causes of medial knee pain. So your physiotherapist, or treating practitioner will take a history of the complaint and carry out a thorough examination of the knee and associated tissues. Assessment will likely include:

• Palpation of the the pes anserinus bursa itself.
• Assessing knee range of movement, hamstring length as well as muscle testing for internal rotation and resisted flexion of the knee.
• Examination will often also involve assessing the performance of functional activities like squatting, lunging, single leg squatting, hopping, jumping and potentially changing of direction and pivoting actions. These functional activities are useful in assessing both for pain but also indications of weakness or undesirable” biomechanics that may uncover a potential cause for the symptoms.

Seeing as pes anserine bursitis symptoms can frequently mimic that of other causes of medial knee pain and may coexist with other knee pathology imaging is often useful when diagnosing as much to rule out other causes as it is to confirm a diagnosis of knee bursitis. Possible imaging options that may be considered useful include:

• X-rays, the use of X-rays can assist in ruling out a stress fracture, arthritis of the knee, or osteochondritis dissecans.
• The use of MRI, or diagnostic ultrasound imaging may also be used to confirm the diagnosis detecting extra fluid in the bursa, as well as note any coexisting issues in the knee.
• Sometimes a lidocaine/corticosteriod injection into the bursa is used when multiple potential causes of medial knee pain are detected. Such injections can help determine the relevance of the pes anserine bursitis to the patient’s overall knee pain by injecting into the bursa and then performing aggravating activities to detect if the injection has eliminated the pain and therefore incriminating the bursa is the likely cause of someones symptoms.

Disclaimer: Sydney Physio Clinic provides this information as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance on Diagnosing Pes Anserinus Bursitis should consult his or her physiotherapist, general practitioner, or sports medicine specialist.