What is the anatomy of the pes anserinus relevant to pes anserine bursitis?

Updated: May 08, 2018
  • Author: P Mark Glencross, MD, MPH, FACOEM, FAAPMR; Chief Editor: Milton J Klein, DO, MBA  more...
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Answer

Pes anserinus (“goose’s foot” in Latin) is the anatomic term used to identify the insertion of the conjoined medial knee tendons into the anteromedial proximal tibia; the name derives from the conjoined tendon’s webbed, footlike structure. From anterior to posterior, the pes anserinus comprises the tendons of the sartorius, gracilis, and semitendinosus muscles, each of which is supplied by a different lower-extremity nerve (femoral, obturator, and tibial, respectively). It lies superficial to the distal tibial insertion of the superficial medial collateral ligament (MCL) of the knee.

This bursa serves as a potential space where motion occurs. Its location is generally accepted to be between the conjoined tendons and the superficial MCL (tibial collateral ligament; see the images below). One recent anatomic investigation by ultrasound found variable locations in 170 individuals, most commonly between tendons and tibia and less frequently between MCL and tendons or among the tendons. [3] For various reasons such as injury or contusion, the synovial cells in the lining of the bursa may secrete more fluid, and the bursa may become inflamed and painful.

 

Location of pes anserinus bursa on medial knee. MC Location of pes anserinus bursa on medial knee. MCL = medial collateral ligament.
Pes anserinus bursa is located on proximomedial as Pes anserinus bursa is located on proximomedial aspect of tibia between superficial medial (tibial) collateral ligament and hamstring tendons (ie, sartorius, gracilis, and semitendinosus). This bursa serves as space where motion occurs between these hamstring tendons and underlying superficial tibial collateral ligament.

Another named bursa that is nearby, the musculi sartorii bursa, is smaller and located between the tendon of the sartorius and the conjoined tendons of the gracilis and the semitendinosus muscles; this bursa can communicate with the pes anserinus bursa proper. For the most part, the 2 bursae are regarded collectively as the pes anserinus bursa. In nonsurgical knees, there is usually no communication between these structures and the knee joint itself.


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