II. Indications

  1. Pes Anserine Bursitis (early intervention)

III. Preparation

  1. Needle: 25 to 27 gauge (1 to 1.5 inch)
  2. Corticosteroid options
    1. Betamethasone (Celestone) 1 ml of 6 mg/ml
    2. Methylprednisolone (Depo-Medrol): 1 ml of 40 mg/ml
  3. Anesthetic
    1. Lidocaine 1%: 2 ml or
    2. Bupivacaine 0.25 or 0.5%: 2 ml

IV. Technique

  1. Images
    1. OrthoKneeInjectPes.jpg
  2. Position patient
    1. Patient lies supine with knee slightly flexed
  3. Mark position of pes anserine bursa (medial knee)
    1. Distal to medial joint line
    2. Sandwiched between ligament and tendon on medial knee
      1. Medial collateral ligament beneath bursa
      2. Medal thigh tendons (e.g. Sartorius) over bursa
    3. Identify point of maximal tenderness
  4. Insert needle perpendicular to tibia
    1. Insert to bone and withdraw 3 mm
    2. Inject Corticosteroid

Images: Related links to external sites (from Bing)

Related Studies (from Trip Database) Open in New Window