See Also
Indications
1. Pes Anserine Bursitis (early intervention)
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
Technique
1. Images
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
References
1. Pfenninger (1994) Procedures, p. 1036-54
2. Cardone (2003) Am Fam Physician 67(10):2147-52
3. Zuber (2002) Am Fam Physician 66(8):1497-1500

Family Practice Notebook

Patients should address specific medical concerns with their physicians.

Although access to this page is not restricted, the information found here is intended for use by medical providers.

This page was written by Scott Moses, MD, last revised on 10/21/2007 and last published on 5/14/2013.

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Family Practice Notebook

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