II. Indications
- Pes Anserine Bursitis (early intervention)
III. Preparation
- Needle: 25 to 27 gauge (1 to 1.5 inch)
-
Corticosteroid options
- Betamethasone (Celestone) 1 ml of 6 mg/ml
- Methylprednisolone (Depo-Medrol): 1 ml of 40 mg/ml
-
Anesthetic
- Lidocaine 1%: 2 ml or
- Bupivacaine 0.25 or 0.5%: 2 ml
IV. Technique
- Images
- Position patient
- Patient lies supine with knee slightly flexed
- Mark position of pes anserine bursa (medial knee)
- Distal to medial joint line
- Sandwiched between ligament and tendon on medial knee
- Medial collateral ligament beneath bursa
- Medal thigh tendons (e.g. Sartorius) over bursa
- Identify point of maximal tenderness
- Insert needle perpendicular to tibia
- Insert to bone and withdraw 3 mm
- Inject Corticosteroid
V. References
- Pfenninger (1994) Procedures, p. 1036-54
- Cardone (2003) Am Fam Physician 67(10):2147-52 [PubMed]
- Zuber (2002) Am Fam Physician 66(8):1497-1500 [PubMed]
