Lower limb
Anserine bursa (Pes anserine bursa)
Bursa anserina
- Origin
- Synovial bursa located on the proximal medial tibia deep to the conjoined tendons of the pes anserinus
- Insertion
- Interposed between the medial collateral ligament (MCL) and the overlying tendons of Sartorius, Gracilis, and Semitendinosus (Say Grace before Tea - SGT)
- Function
- Facilitates frictionless movement of the three pes anserinus tendons over the tibial cortex and MCL
- Innervation
- Sensory branches of the saphenous nerve
- Movement & chain
- Loaded during knee flexion and internal tibial rotation
- Palpation
- Tender on palpation ~4-5 cm distal to the medial joint line over the anteromedial tibia
- Clinical
- Anserine bursitis (pes anserine pain syndrome); common cause of medial knee pain in middle-aged women with knee osteoarthritis, obesity, and runners; frequently misdiagnosed as medial meniscus tear
- Segmental innervation
- L2, L3, L4 spinal segments
- In clinical practice
- Palpation mapping distinguishing joint line tenderness (meniscal tear) from anserine tenderness (4 cm distal); ultrasound-guided corticosteroid injection and hamstring stretching
- Region in the model
- Lower limb