To differentiate these conditions, a diagnostic ultrasound scan or an MRI is required. However, there is often some overlap between the two. The cause and symptoms of a tendon problem can vary compared with a bursa issue. They often occur together (however not always) and it is important to ascertain whether your issue is a tendon or bursa, as this can influence your treatment options. If the tendons become painful, this is known as a pes anserine tendinopathy, whereas an irritated bursa is called a pes anserine bursitis. you do too much too soon, then the tendons and the bursa can become inflamed and cause pain (see image below). However, if this is not the case or you increase your training too quickly, i.e. If you do not overload these structures, they can withstand repetitive load and the tendon and bursa will not become inflamed.
This bursa acts as a shock absorber, reducing friction and allowing smooth movement to occur between the structures. To help reduce the risk of an overuse injury at this ‘anatomical hotspot,’ the body has a thin sac called the bursa. For example, during prolonged walking, running or cycling. Overuse can occur due to the constant transmission of compressive and tensile force on the tendon, during repetitive knee movement. The pes anserine tendon is a common site of overuse. ‘Locking’ and ‘catching’ of the knee joint also occurs with cartilage tears, but not in cases of pes anserine tendinopathy. A cartilage (meniscal tear) specifically the medial meniscus also gives pain on the inside of the knee but is normally associated with swelling and a restriction in the movement of the knee. Pes anserine tendinopathy is associated with localised pain and tenderness on the inside of the knee joint. Pes anserine tendinopathy vs cartilage(meniscal) tear If this sounds like your problem, read on below… Other conditions that can mimic pes anserine tendinopathy: Tenderness when you touch the inside of the leg just below the knee joint.Pain is aggravated with repetitive activities that bend the knee such as running, cycling and squatting.The main symptom is pain on the inside of the leg just beneath the knee joint.What are the symptoms of pes anserine tendinopathy? If the pain continues shockwave therapy or an ultrasound guided steroid injection is an effective treatment option for more stubborn, recalcitrant cases. Physiotherapy will involve specific exercises to rehabilitate the tendons and stimulate a healing process within the tendon. Treatment consists of ice, activity modification and physiotherapy. The pain often eases with activity and is worse afterwards. The pain can be quite sharp if the pes anserine bursa is involved as well as the tendon. Pes anserine tendinopathy is an overuse injury which is often aggravated with activities such as running, cycling or squatting. These tendons, that attach the muscles to the bone, are involved in any activities that involve bending the knee. The pes anserinus is the combined insertion of the three hamstring tendons which attach to the inside of the leg, just below the knee joint. DeQuervains Tenosynovitis (thumb tendinitis).Triangular fibrocartilage complex (TFCC).Osteoarthritis (OA) of base of the thumb.Hydrodistension Injection for Frozen Shoulder.How is diagnostic ultrasound used at Complete Injections?.