Orthopedics Book

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Pes Anserine Bursa Injection

Aka: Pes Anserine Bursa Injection, Pes Anserine Injection
  1. See Also
    1. Knee Injection
    2. Joint Injection
    3. Injectable Corticosteroid
  2. Indications
    1. Pes Anserine Bursitis (early intervention)
  3. 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
  4. 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
  5. References
    1. Pfenninger (1994) Procedures, p. 1036-54
    2. Cardone (2003) Am Fam Physician 67(10):2147-52 [PubMed]
    3. Zuber (2002) Am Fam Physician 66(8):1497-1500 [PubMed]

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