COMPREHENSIVE REVIEW OF PES ANSERINUS SYNDROME: ETIOLOGY, DIAGNOSIS, AND MANAGEMENT

R. Aicale¹, R. Pellegrino^2,3*, D.I. Angelo⁴, R. Mottola⁵, R. Saggini⁶, C. Ruosi⁵ and D. Tarantino⁷

¹ Department of Orthopaedic and Trauma Surgery, Casa di Cura di Bernardini, Taranto, Italy;
² Department of Medicine, LUM University, Italy;
³ Santa Chiara Institute, Lecce, Italy;
⁴ Department of Innovative Technologies in Medicine & Dentistry, University “G. d’Annunzio” of Chieti-Pescara, Italy;
⁵ Department of Public Health, University of Naples Federico II, Naples, Italy;
⁶ Faculty of Psychology, eCampus University, Novedrate, Italy;
⁷ Department of Orthopaedic Rehabilitation, Campolongo Hospital, 84025 Marina di Eboli, Salerno, Italy.

*Correspondence to:
Raffaello Pellegrino, MD,
Department of Medicine,
LUM University, Italy.
e-mail: r.pellegrino@lum.it

Received: 20 September, 2024 Accepted: 18 December, 2024

ISSN 2975-044X (online) ISSN 2038-4106 (print) Copyright © by BIOLIFE 2024 This publication and/or article is for individual use only and may not be further reproduced without written permission from the copyright holder. Unauthorized reproduction may result in financial and other penalties. Disclosure: All authors report no conflicts of interest relevant to this article.

ABSTRACT

Pes anserinus is an anatomical structure located on the medial aspect of the knee, where the tendons of the sartorius, gracilis, and semitendinosus muscles conjoin and insert onto the anteromedial surface of the proximal tibia, approximately 5 cm distally to the medial knee joint space. Pathological conditions associated with pes anserinus, most notably pes anserinus bursitis, are common sources of medial knee pain, particularly among athletes, individuals with osteoarthritis (OA), and obese patients. Since this peculiar structure is made by the insertion of three tendons, a true difference between bursitis and tendinopathy is hard to identify in the context of pes anserinus. Diagnosis of pes anserinus syndrome (PAS) is primarily clinical, supported by imaging techniques like ultrasound or magnetic resonance imaging to rule out other causes of medial knee pain. Treatment often involves conservative measures such as rest, cryotherapy, nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, and injections. In refractory cases, surgical intervention may be considered. Understanding the anatomy and pathology of pes anserinus is essential for clinicians to accurately diagnose and manage conditions affecting this structure. Comprehensive knowledge of its clinical implications can lead to more effective treatment strategies and improved patient outcomes. This article provides a concise overview of the anatomical features, common pathologies, diagnostic approaches, and treatment modalities related to PAS, highlighting its significance in musculoskeletal health and disease.

KEYWORDS: tendinopathy, pes anserinus, pes anserine; pes anserinus syndrome; anserine syndrome; pes anserinus tendinopathy; pes anserinus bursitis