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FP Essent 2018 07;470:16-20

Uniformed Services University Department of Family Medicine, 4301 Jones Bridge Road A1038, Bethesda, Maryland 20814-4799.

Physical therapy (PT) modalities are a diverse group of treatments for musculoskeletal pain. Iontophoresis, phonophoresis, kinesiology taping, laser therapy, and myofascial release are some of the most commonly used and are best considered as adjuncts to exercise. Each modality is relatively safe, but none is supported by high-quality evidence in the management of most musculoskeletal conditions. Read More

Prim Care 2018 Jun;45(2):289-303

Rheumatology Fellowship, San Antonio Uniformed Services Health Education Consortium (SAUSHEC), Uniformed Services University of the Health Sciences, San Antonio Military Medical Center, 3551 Roger Brooke Drive, San Antonio, TX 78234, USA.

Soft tissue musculoskeletal pain disorders are common in the primary care setting. Early recognition and diagnosis of these syndromes minimizes patient pain and disability. This article gives a brief overview of the most common soft tissue musculoskeletal pain syndromes. Read More

Sultan Qaboos Univ Med J 2018 Feb 4;18(1):e97-e99. Epub 2018 Apr 4.

Department of Orthopaedics & Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

anserine bursitis (PAB) is an inflammation of the located between the medial aspect of the and the hamstring muscles. It is common in patients with degenerative or inflammatory knee arthritis, usually has a self-limiting course and tends to respond well to conservative treatment. However, painful PAB directly following total knee replacement surgery is rare. Read More

Curr Sports Med Rep 2018 Feb;17(2):41

University of Florida, Orthopaedics and Sports Medicine Institute, Gainesville, FL.

Radiol Oncol 2017 Dec 29;51(4):401-406. Epub 2017 Nov 29.

Department of Radiology, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey.

Background: This study investigated the presence of bursitis in the medial compartment of the knee (pes anserine, semimembranosus-tibial collateral ligament, and medial collateral ligament bursa) in osteoarthritis, chondromalacia patella and medial meniscal tears.

Patients And Methods: Radiological findings of 100 patients undergoing magnetic resonance imaging with a preliminary diagnosis of knee pain were retrospectively evaluated by two radiologists. The first radiologist assessed all patients in terms of osteoarthritis, chondromalacia patella and medial meniscal tear. Read More

Medicine (Baltimore) 2017 Oct;96(43):e8330

aDepartment of Orthopedic Surgery, Changwon Gyeongsang National University Hospital, Incheon bDepartment of Anesthesiology and Pain Medicine, Myongji Hospital, College of Medicine, Seonam University, Goyang cDepartment of Anesthesiology and Pain Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Incheon dDepartment of Anesthesiology and Pain Medicine, Catholic Kwandong University of Korea College of Medicine, International ST. Mary's Hospital, Incheon eDepartment of Nursing, Kyung-In Women's University, Incheon, Republic of Korea.

Rationale: Pes anserine (PA) bursitis is an inflammatory condition of the medial knee. The PA bursa becomes more painful when infected, damaged, or irritated. Although various treatment options have been attempted to treat PA bursitis, optimal treatments are still debated. Read More

Adv Biomed Res 2017 6;6:70. Epub 2017 Jun 6.

Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Knee pain, is one of the most common causes of patients' referring to physiatric clinics, and several factors, are involved in its creation. One of these factors is pes anserine bursitis (PAB) for which various treatment methods are used. This study aims to investigate the effect of this method on reducing chronic pain in these patients. Read More

Open Orthop J 2017 17;11:397-403. Epub 2017 May 17.

The Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Introduction: Osteochondroma is a common benign bone tumor, protruding from the underlying normal bone. Osteochondromas can cause pain depending on their location and size. The pes anserinus is located at the proximal medial side of the tibia, where the tendinous insertions of the sartorius, gracilis and semitendinosus muscles collectively attach. Read More

J Phys Ther Sci 2016 Jul 29;28(7):1993-7. Epub 2016 Jul 29.

Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Acıbadem University, Turkey.

[Purpose] The aims of this study were twofold. The first was to compare the functional capacity and pain of patients with knee osteoarthritis (KOA), with or without pes anserine tendino-bursitis (PATB). The second is to compare the efficacy of two treatment methods (physical therapy and corticosteroid injection) for patients with PATB. Read More

Am Fam Physician 2016 Feb;93(3):170

Salinas, CA, USA.

J Altern Complement Med 2015 Aug 17;21(8):480-4. Epub 2015 Jun 17.

3 Department of Medicine and Science of Aging, G. D'Annunzio University , Chieti, Italy .

Background: Pes anserine bursitis strongly affects quality of life in patients with osteoarthritis. Treatment includes nonsteroidal anti-inflammatory drugs (NSAIDs), physiotherapy, and injections of corticosteroid, with highly variable responses; recovery can take 10 days to 36 months. Mesotherapy is a minimally invasive technique consisting of subcutaneous injections of bioactive substances. Read More

J Athl Enhanc 2014 Jan;3(1)

Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA ; Sports Medicine Biodynamics Center and Human Performance Laboratory, Cincinnati, Ohio, USA ; Department of Pediatrics and Orthopaedic Surgery, University of Cincinnati, Cincinnati, Ohio, USA ; Departments of Biomedical Engineering and Rehabilitation Sciences, University of Cincinnati, Cincinnati, Ohio, USA.

Background: The purpose of this study was to determine if there is a sex difference in the prevalence of specific patellofemoral disorders that cause anterior knee pain in adolescent basketball players undergoing pre-participation screening.

Methods: Setting: Biomechanical Laboratory.

Methods: Participants: A total of 810 (688 female and 122 male) basketball players from a single county public school district. Read More

Clin Rheumatol 2015 Mar 6;34(3):529-33. Epub 2014 May 6.

Faculty of Medicine, Department of Radiology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey,

The aim of this prospective study was to determine the prevalence of pes anserine bursitis (PAB) in patients with osteoarthritis. A total of 85 patients with primary knee osteoarthritis diagnosed according to the American College of Rheumatology (ACR) criteria were included in the study. The patients were divided into four groups using the Kellgren-Lawrence staging system. Read More

J Sport Rehabil 2015 Feb 12;24(1):31-5. Epub 2014 Mar 12.

Dept of Pediatric Orthopaedics and Sports Medicine, Phoenix Children's Hospital, Phoenix, AZ.

Objectives: To determine if sport specialization increases the risk of anterior knee pain in adolescent female athletes.

Design: Retrospective cohort epidemiology study.

Methods: Female basketball, soccer, and volleyball players (N = 546) were recruited from a single county public school district in Kentucky consisting of 5 middle schools and 4 high schools. Read More

J Orthop Sports Phys Ther 2014 Jan;44(1):41

Naval Special Warfare Group ONE, San Diego, CA.

The patient was a 25-year-old man who was serving in the military. He was referred to a physical therapist for a progressively worsening painful snapping sensation in the posteromedial left knee region. Prior magnetic resonance imaging for the left knee was interpreted as normal, except for a mild fluid signal about the left pes anserine bursa. Read More

Eur J Radiol 2013 Nov 12;82(11):e703-6. Epub 2013 Aug 12.

Department of Medical Imaging, University Hospital of Heraklion, Crete, Greece. Electronic address:

Objective: Medial tibial condyle bone marrow edema (BME), associated with soft tissue edema (STe) surrounding the medial collateral ligament, was incidentally observed in MRI examinations of young and athletic individuals. The aim of the present study was to 1. Prospectively investigate the association between these findings and coexistence of localized pain, and 2. Read More

Rheumatol Int 2013 Mar 5;33(3):711-7. Epub 2012 May 5.

Department of Physical Medicine and Rehabilitation, İstanbul University, Istanbul, Turkey.

We aimed to investigate (1) the probable correlation between clinical and ultrasonographic findings in chronic painful primary knee OA patients referred with acute flare-ups and (2) the impact of diagnostic ultrasonography (US) to determine the real source of pain in these patients. We included 100 patients consecutively who were admitted to our outpatient unit with a pain complaint on a single knee with the diagnosis of primary knee OA according to the ACR criteria. The control group consisted of the patients with pain-free knees at least during the last month, who were already included in the study group. Read More

Case Rep Med 2011 1;2011:491470. Epub 2011 Jun 1.

Department of Orthopedic Oncology, Beijing JiShui Tan Hospital, Peking University, 31 Xinjiekou East Street, Xicheng District, Beijing 100035, China.

Pigmented villonodular synovitis (PVNS) is a rare, benign, proliferating disease affecting the synovium of joints, bursae, and tendon sheaths. Involvement of bursa (PVNB, pigmented villonodular bursitis) is the least common, and only few cases of exclusively extra-articular PVNB of the pes anserinus bursa have been reported so far. We report a case of extra-articular pes anserine PVNB along with a review of the literature. Read More

Rev Bras Reumatol 2010 May-Jun;50(3):313-27

Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil.

Knee pain is a common complaint in clinical practice, and pes anserinus tendino-bursitis syndrome (PATB) has been frequently diagnosed based only on clinical features that may cause equivocal interpretations. Patients complain of characteristic spontaneous medial knee pain with tenderness in the inferomedial aspect of the joint. Studies with different imaging modalities have been undertaken during the last years to identify whether these patients suffer from bursitis, tendinitis, or both. Read More

J Vasc Surg 2010 Apr;51(4):893-9

Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

Purpose: Computed tomography venography (CTV) with three-dimensional reconstruction can provide complementary road maps for varicose vein (VV) surgery. The purpose of this study is to verify the role of CTV in the treatment of VV in terms of advantages and complications.

Methods: Ninety-four consecutive patients with VV underwent conventional high ligation, stripping, and varicosectomy by a single vascular surgeon in 2007. Read More

Bull NYU Hosp Jt Dis 2010 ;68(1):46-50

Department of Diagnostic Imaging, The Ottawa Hospital, General Campus, Ottawa, Ontario, Canada.

While hospitalized with polymyositis, a medically complex 56-year-old male experienced an acute exacerbation of gout. Both ultrasound and magnetic resonance imaging cross-sectional modalities were used to detect, localize, and characterize a soft tissue mass. The tumor was ultimately found to be secondary to gouty inflammation of the pes anserine bursa, a previously unrecognized manifestation of acute gout. Read More

Knee 2008 Dec 17;15(6):423-38. Epub 2008 Jun 17.

Department of Radiology, Boston University Medical Center, FGH Building, 3rd Floor, 820 Harrison Ave, Boston, MA 02118, United States.

Cystic lesions around the knee are a diverse group of entities, frequently encountered during routine MRI of the knee. These lesions range from benign cysts to complications of underlying diseases such as infection, arthritis, and malignancy. MRI is the technique of choice in characterizing lesions around the knee: to confirm the cystic nature of the lesion, to evaluate the anatomical relationship to the joint and surrounding tissues, and to identify associated intra-articular disorders. Read More

Orthopedics 2008 Apr;31(4):306, 407-8

University of North Dakota School of Medicine, Grand Forks, North Dakota, USA.

Osteoarthritis Cartilage 2008 Jun 22;16(6):647-53. Epub 2008 Jan 22.

Primary Care Musculoskeletal Research Centre, Keele University, Keele, Staffordshire, UK.

Objective: To estimate the contribution of selected non-articular conditions (NACs) to pain severity and functional limitation in community-dwelling older adults with knee pain.

Design: Population-based, cross-sectional study of 745 adults aged 50 years and over with knee pain. Self-complete questionnaires, clinical history and physical examination were used to identify the presence of selected NACs that could cause pain around the knee. Read More

J Ark Med Soc 2007 Nov;104(5):112

Knee 2007 Oct 31;14(5):402-7. Epub 2007 Jul 31.

Division of Musculoskeletal Oncology, Department of Orthopedics, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.

Pigmented villonodular synovitis (PVNS) is a benign but potentially aggressive lesion, characterized by synovial villonodular proliferation with hemosiderin pigmentation and stromal infiltration of histiocytes and giant cells. This consists of a common family of lesions, including localized and diffuse forms of pigmented villonodular synovitis, giant cell tumor of the tendon sheath (nodular tenosynovitis) and the very rare cases of extra-articular pigmented villonodular synovitis arising from the bursa (pigmented villonodular bursitis or diffuse giant cell tumor of the tendon sheath). The purpose of this paper is to present two rare cases of pigmented villonodular bursitis arising from the pes anserinus bursa. Read More

Skeletal Radiol 2005 Jul 7;34(7):395-8. Epub 2005 Jun 7.

The Department of Radiology, Royal National Orthopaedic Hospital NHS Trust, Brockley Hill, Stanmore, Middlesex, HA6 4LP, UK.

Objective: To determine the prevalence and associated clinical symptoms of pes anserine bursitis in symptomatic adult knees.

Materials And Methods: A retrospective review was performed of the reports of 509 knee MRI studies obtained from July 1998 to June 2004 on 488 patients presenting to an orthopaedic clinic with knee pain suspected to be due to internal derangement. The MRI studies and case histories of all patients reported to have pes anserine bursitis were reviewed. Read More

J Korean Med Sci 2005 Feb;20(1):109-12

Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea.

The objectives of this study were to assess the ultrasonographic (US) findings in patients with knee osteoarthritis (OA) with pes anserinus tendinitis or bursitis (PATB) syndrome and to determine the correlation between the US findings and the response to local corticosteroid injection. We prospectively studied 26 patients with knee OA with clinically diagnosed PATB syndrome. A linear array 7 MHz transducer was used for US examination of the knee. Read More

Skeletal Radiol 2004 Apr 27;33(4):187-209. Epub 2004 Feb 27.

Department of Radiology, Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford, OX3 7LD, UK.

This review presents a comprehensive illustrated overview of the wide variety of cystic lesions around the knee. The aetiology, clinical presentation, MRI appearances and differential diagnosis are discussed. Bursae include those related to the patella as well as pes anserine, tibial collateral ligament, semimembranosus-tibial collateral ligament, iliotibial and fibular collateral ligament-biceps femoris. Read More

Am Fam Physician 2003 Sep;68(5):917-22

University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.

Knee pain is a common presenting complaint with many possible causes. An awareness of certain patterns can help the family physician identify the underlying cause more efficiently. Teenage girls and young women are more likely to have patellar tracking problems such as patellar subluxation and patellofemoral pain syndrome, whereas teenage boys and young men are more likely to have knee extensor mechanism problems such as tibial apophysitis (Osgood-Schlatter lesion) and patellar tendonitis. Read More

Singapore Med J 2002 Sep;43(9):485-91

Department of Diagnostic Radiology, Singapore General Hospital.

Many cystic lesions occur around the knee and may produce overlapping clinical features, rendering the clinical diagnosis difficult. A 50-year-old woman presented with a soft tissue swelling on the medial aspect of her right knee. The diagnosis of pes anserine bursitis was made, based on typical MR imaging features. Read More

Orthopedics 1997 Nov;20(11):1100; 1092-4

St Louis University, Health Sciences Center, MO, USA.

Am Fam Physician 1996 May;53(7):2317-24

Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.

Bursitis is a common cause of lower extremity pain in patients presenting to primary care physicians. Several bursae in the lower extremity account for most of these injuries, including the ischiogluteal, greater trochanteric, pes anserine, medial collateral, prepatellar, popliteal and retrocalcaneal. Often the symptoms are mild, with the patient successfully self-treating through activity modification and other conservative measures. Read More

Radiology 1995 Feb;194(2):525-7

Department of Radiology, School of Medicine, University of California San Francisco 94143.

Purpose: To determine the magnetic resonance (MR) imaging appearance of acute pes anserine bursitis.

Materials And Methods: Four patients (aged 40-50 years) with presumed internal derangements of the knee underwent MR imaging; at that time, collections of fluid were found in the pes anserine bursa, but no other abnormalities were noted.

Results: Pes anserine bursitis was clinically diagnosed in all four patients when MR findings and physical examination findings were correlated. Read More

J Comput Assist Tomogr 1993 Jan-Feb;17(1):137-40

Department of Radiology, Medical College of Ohio, Toledo 43699-0008.

A case of chronic, nonspecific synovial inflammation presenting as a mass in the pes anserine bursa is demonstrated by MRI. The lesion was well demarcated and surrounded by a low intensity rim. On spin echo images it was homogeneous and of intermediate signal intensity, whereas on T2-weighted images it showed scattered areas of high signal producing a heterogeneous pattern. Read More

J Arthroplasty 1992 Mar;7(1):63-70

Department of Orthopedics, Mayo Clinic, Rochester, MN 55905.

Sixteen total knee arthroplasties performed between 1977 and 1985 in 13 patients with prior ipsilateral hip arthrodesis or ankylosis were studied to determine the preferred sequence and long-term follow-up of procedures in this clinical setting. Twelve of 16 underwent fusion takedown and total hip arthroplasty prior to knee replacement. The average age at total knee arthroplasty was 52. Read More

Phys Sportsmed 1992 Feb;20(2):66-77

In brief Knee bursitis often mimics other brief Pathologies, making correct diagnosis necessary to initiate appropriate treatment. Most commonly affected are the prepatellar, pes anserine, tibial collateral ligament, and two infrapatellar bursae. Other common bursitic conditions include Baker's cysts and posttraumatic adventitious hemorrhagic bursitis. Read More

Arch Phys Med Rehabil 1991 Apr;72(5):336-7

Physical Medicine and Rehabilitation Service, Fitzsimons Army Medical Center, Aurora, CO 80045-5001.

Numerous studies have addressed saphenous nerve entrapment at the level of the adductor canal. In this case, we report an entrapment syndrome located further distally occurring as part of an athletic overuse injury. Distal tibial pain, initially managed as a stress fracture, resolved when a pes anserine bursitis was treated. Read More

ONA J 1979 Oct;6(10):418-9