Pes Anserine Bursitis

In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan.


Bursitis is the general term used to describe inflammation of any bursa. The bursae are cavitary structures lined with synovial tissue that cushions and assists during the motion of joints and muscles. Bursitis is usually accompanied by tenderness; however, swelling and redness may also be present.

Pes anserine bursitis is a clinical entity associated with pain at the medial knee and the proximal medial tibial region. A more generic term, pes anserine pain syndrome, has been applied to refer to medial knee pain, which may or may not include inflammation of the bursal sac. This article focuses on the clinical entity of pes anserine bursitis unless otherwise specifically stated.

Sartorius, gracilis, and semitendinous tendons insert roughly 5 cm distal to the medial knee joint line forming a structure that mimics the natatory membrane of the goose and hence is called "goosefoot" or pes anserinus in Latin. The 3 muscles are primary knee flexors and play a secondary role in tibial internal rotation with a resultant protective effect against rotation and valgus stress. There are thirteen bursae around the knee, one of them is the pes anserinus bursa. The pes anserinus bursa is situated immediately beneath the pes anserinus, separating it from the upper medial tibia. Usually, there is no communication between the pes anserinus bursa and the knee joint.

In 1937, Moschcowitz was the first to describe pes anserinus bursitis changes when he reported the complaint of knee pain almost exclusively in females with pain complaint with ascending or descending stairs or rising from a seated position or difficulty with knee flexion. It is challenging to differentiate between pes anserine bursitis and tendinitis as both the tendons and bursa are anatomically close to each other. However, management is the same.

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