| Pes anserine bursitis | |
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| Pes anserine is on the lower right side of image (pes anserine bursa lies beneath) | |
| Specialty | Orthopedic |
Pes anserine bursitis is an inflammatory condition of the medial (inner) knee at the anserine bursa, a sub muscular bursa, just below the pes anserinus.
The pes anserinus is where the tendons of the sartorius, gracilis, and semitendinosus join at the medial knee, [1] into the anteromedial proximal tibia.
Pes anserine bursitis may result from stress, overuse, obesity and trauma to this area. An occurrence of pes anserine bursitis commonly is characterized by pain at the medial knee and upper tibial region, especially when climbing stairs, tenderness, and local swelling. [2]
The etymology of the name relates to the insertion of the conjoined tendons into the anteromedial proximal tibia. From anterior to posterior, the pes anserinus is made up of the tendons of the sartorius, gracilis, and semitendinosus muscles. The tendon's name, which literally means "goose's foot," was inspired by the pes anserinus's webbed, footlike structure. The conjoined tendon lies superficial to the tibial insertion of the medial collateral ligament (MCL) of the knee.[ citation needed ]
Patients will typically present with pain at the medial knee when climbing stairs, rising from chairs or sitting with legs crossed. The site is sometimes swollen, but not always. The likelihood of per anserine bursitis is increased in patients with osteoarthritis. Sometimes they report weakness or decreased range of motion. The physician examines the knee in full extension, looking for tenderness in the medial knee joint and across the proximal, medial tibial region, and feels for tenderness along the medial tendons of the per anserine when the knee is flexed at 90 degrees.[ citation needed ]
Imaging is not commonly used for this diagnosis.[ citation needed ]
Pes anserine bursitis can be treated with a variety of physical therapy treatments, steroids to reduce inflammation, or surgery if necessary. Physical therapy treatments include therapeutic ultrasound, electrical stimulation (E-stim), rehabilitative exercises, and ice. [2] Therapeutic ultrasound and E-stim deliver medication deep to the bursa to reduce inflammation. The rehabilitative exercises are done with the intention of stretching and strengthening the hip abductors, quadriceps, and hamstrings. [2] These stretches have the potential to significantly reduce the tension over the pes anserine bursa.[ citation needed ]
The leg is the entire lower limb of the human body, including the foot, thigh or sometimes even the hip or buttock region. The major bones of the leg are the femur, tibia, and adjacent fibula. The thigh is between the hip and knee, while the calf (rear) and shin (front) are between the knee and foot.
In humans and other primates, the knee joins the thigh with the leg and consists of two joints: one between the femur and tibia, and one between the femur and patella. It is the largest joint in the human body. The knee is a modified hinge joint, which permits flexion and extension as well as slight internal and external rotation. The knee is vulnerable to injury and to the development of osteoarthritis.
In human anatomy, a hamstring is any one of the three posterior thigh muscles between the hip and the knee.
The sartorius muscle is the longest muscle in the human body. It is a long, thin, superficial muscle that runs down the length of the thigh in the anterior compartment.
The tibia, also known as the shinbone or shankbone, is the larger, stronger, and anterior (frontal) of the two bones in the leg below the knee in vertebrates ; it connects the knee with the ankle. The tibia is found on the medial side of the leg next to the fibula and closer to the median plane. The tibia is connected to the fibula by the interosseous membrane of leg, forming a type of fibrous joint called a syndesmosis with very little movement. The tibia is named for the flute tibia. It is the second largest bone in the human body, after the femur. The leg bones are the strongest long bones as they support the rest of the body.
The medial collateral ligament (MCL), also called the superficial medial collateral ligament (sMCL) or tibial collateral ligament (TCL), is one of the major ligaments of the knee. It is on the medial (inner) side of the knee joint and occurs in humans and other primates. Its primary function is to resist valgus forces on the knee.
The biceps femoris is a muscle of the thigh located to the posterior, or back. As its name implies, it consists of two heads; the long head is considered part of the hamstring muscle group, while the short head is sometimes excluded from this characterization, as it only causes knee flexion and is activated by a separate nerve.
The adductor magnus is a large triangular muscle, situated on the medial side of the thigh.
The gracilis muscle is the most superficial muscle on the medial side of the thigh. It is thin and flattened, broad above, narrow and tapering below.
The semimembranosus muscle is the most medial of the three hamstring muscles in the thigh. It is so named because it has a flat tendon of origin. It lies posteromedially in the thigh, deep to the semitendinosus muscle. It extends the hip joint and flexes the knee joint.
The semitendinosus is a long superficial muscle in the back of the thigh. It is so named because it has a very long tendon of insertion. It lies posteromedially in the thigh, superficial to the semimembranosus.
Dog anatomy comprises the anatomical studies of the visible parts of the body of a domestic dog. Details of structures vary tremendously from breed to breed, more than in any other animal species, wild or domesticated, as dogs are highly variable in height and weight. The smallest known adult dog was a Yorkshire Terrier that stood only 6.3 cm (2.5 in) at the shoulder, 9.5 cm (3.7 in) in length along the head and body, and weighed only 113 grams (4.0 oz). The heaviest dog was an English Mastiff named Zorba which weighed 314 pounds (142 kg). The tallest known adult dog is a Great Dane that stands 106.7 cm (42.0 in) at the shoulder.
The knee examination, in medicine and physiotherapy, is performed as part of a physical examination, or when a patient presents with knee pain or a history that suggests a pathology of the knee joint.
The tuberosity of the tibia, tibial tuberosity or tibial tubercle is an elevation on the proximal, anterior aspect of the tibia, just below where the anterior surfaces of the lateral and medial tibial condyles end.
The saphenous nerve is the largest cutaneous branch of the femoral nerve. It is derived from the lumbar plexus (L3-L4). It is a strictly sensory nerve, and has no motor function. It commences in the proximal (upper) thigh and travels along the adductor canal. Upon exiting the adductor canal, the saphenous nerve terminates by splitting into two terminal branches: the sartorial nerve, and the infrapatellar nerve. The saphenous nerve is responsible for providing sensory innervation to the skin of the anteromedial leg.
Pes anserinus refers to the conjoined tendons of three muscles of the thigh. It inserts onto the anteromedial surface of the proximal tibia. The muscles are the sartorius, gracilis and semitendinosus sometimes referred to as the guy ropes. The name "goose foot" arises from the three-pronged manner in which the conjoined tendon inserts onto the tibia.
The knee bursae are the fluid-filled sacs and synovial pockets that surround and sometimes communicate with the knee joint cavity. The bursae are thin-walled, and filled with synovial fluid. They represent the weak point of the joint, but also provide enlargements to the joint space. They can be grouped into either communicating and non-communicating bursae or, after their location – frontal, lateral, or medial.
Medial knee injuries are the most common type of knee injury. The medial ligament complex of the knee consists of:
The anserine bursa is a sub muscular bursa located deep to the pes anserinus on the anteromedial proximal tibia. Pes anserine bursitis is a common inflammatory condition of the anserine bursa.