- Obese middle aged women
- Patients 50-80 with OA knees (common)
- Young individuals in sporting activities
Usually women (maybe due to broader pelvis > greater angulation of legs at the knees > additional stress placed on these structures)
HOW CAN IT HAPPEN?
- Acute trauma to medial knee
- Athletic overuse
- Chronic mechanical and degeneative processes
- Pain over the proximal tibia at the insertion of the conjoined tendons (S.G.St) approx 2-5 cm below the anteriomedial joint margin of the knee
- Local pain in area of bursa, on palpation no pain at joint line (unless other conditions are active)
Sports related variant...
- Pain on resisted internal rotation and flexion of the knee
- Valgus stress may reproduce symptoms (easy to mix up with MCL injury, typically painful tenderness in association with MCL injuries is superior and posterior to the pes anserinus bursa)
- If swelling can be traced more proximally along the pes anserinus tendons, a formal tendinitis may be present and a snapping of the pes anserine tendons can occur
- An exotosis of the tibia has been described in athletes and may contribute to chronic symptoms (exotosis = formation of new bone on the surface of bone)