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Per Anserine Bursitis Cheat Sheet (DRAFT) by

Presentation, management

This is a draft cheat sheet. It is a work in progress and is not finished yet.


- Sartorius, gracilis and semite­ndi­nosus tendons
- Knee flexors and tibial internal rotation - helps protect knee from rotary and valgus stress, contracts eccent­rically during terminal knee ext to stop excess ext rot
- Bursa reduces frictions between tendons and tibia
- Stresses trigger synovial linging to produce excessive fluid - painful inflam­mation

Risk Factors

- Obesity
- Knee OA
- Diabetes
- Female gender (wider pelvic and increased Q angle)
- Runners, breast­stroke swimers, athletes - cuttin­g/side to side movement
- Hamstring tightness
- Lack of knee extension
- Improp­er/­rapid changes in training
- Can co-exist with other knee disorders - Osgood schlatter, plica irrita­tion, meniscus injury, degene­ration
- Pes planus­/valgus knee


- Difficult to localise pain for patient
- Mild-M­oderate pain over medial tibia near insertion of conjoined tendons , 5cm below medial joint line of the knee and 3-4 cm medial to TT
- Aggravted by descending stairs or arising from seated position + side to side movement
- ROM - pain during knee flexion, RROM knee int rot /knee flex
- Swelling can occur
- Assess hamstring flexib­ility, hip abductor weakness, pes planus - increase valgus stress of the knee


- Not requited unless bony pathology
- US/MRI usually considered


- Meniscus injury
- Ligame­ntous sprain
- Tendin­opathy
- Neoplasm
- Tibial stress f#
- Inflam­matory Arthro­pathy
- Osteoc­hon­dritis dissecans
- Lx radicu­lopathy
- Plica irritation
- Osteon­ecrosis
- OA


- Ice , US, e-stim, NSAIDs
- Myofascial release and stretching of sartorius, gracilis, semite­ndi­nosus
- SMT of LS + LL
- Arch supports
- Stretching of hamstring, adductors, quads, gastro
- Streng­thening of hip abductors
- Overweight pts - diet and exercise
- If non responsive consider injection and later on surgical interv­ention