Abstract
The aim of this prospective study was to determine the prevalence of pes anserine bursitis (PAB) in patients with osteoarthritis. A total of 85 patients with primary knee osteoarthritis diagnosed according to the American College of Rheumatology (ACR) criteria were included in the study. The patients were divided into four groups using the Kellgren-Lawrence staging system. The knee X-rays evaluated according to this system indicated that 15.6 % of patients were grade 1, 34.1 % grade 2, 37.1 % grade 3, and 13.5 % grade 4. Ultrasonography (USG) was performed on both knees by a radiologist experienced in musculoskeletal system ultrasonography and unaware of the patients’ physical examination or direct X-ray findings. The presence of PAB, longest diameter of bursitis, and area of bursitis were recorded. The average age of the 11 male and 74 female patients included in the study was 58.9 ± 9.0 years. A total of 170 knees of 85 patients were examined. The incidence of bursitis was significantly higher in females (p = 0.026). The incidence of bursitis on ultrasound was 20 % (34/170). There was a statistical difference between the grades for bursitis incidence (p = 0.004). There was a significant positive correlation between both the longest length (p = 0.015, r = 0.187) and area (p = 0.003, r = 0.231) of PAB with osteoarthritis grade. The mean age of bursitis patients was higher than that of those without the condition (p = 0.038). In addition, the osteoarthritis (OA) grade and bursitis prevalence increased as the patients’ age increased, and these increases were statistically significant (p < 0.001). PAB is easily evaluated with ultrasonography. Pes anserine bursitis was observed in one out of every five symptomatic OA patients and was more common in female patients and with advanced age. A positive correlation was found between OA grade and PAB size and area.
Similar content being viewed by others
References
Wood LR, Peat G, Thomas E, Duncan R (2008) The contribution of selected non-articular conditions to knee pain severity and associated disability in older adults. Osteoarthr Cartil 16:647–653
Butcher JD, Salzman KL, Lillegard WA (1996) Lower extremity bursitis. Am Fam Physician 53:2317–2324
Imani F, Rahimzadeh P, Abolhasan Gharehdag F, Faiz SH (2013) Sonoanatomic variation of pes anserine bursa. Korean J Pain 26:249–254
Gnanadesigan N, Smith RL (2003) Knee pain: osteoarthritis or anserine bursitis? J Am Med Dir Assoc 4:164–166
Alvarez-Nemegyei J (2007) Risk factors for pes anserinus tendinitis/bursitis syndrome: a case control study. J Clin Rheumatol 13:63–65
Cohen SE, Mahul O, Meir R, Rubinow A (1997) Anserine bursitis and non-insulin dependent diabetes mellitus. J Rheumatol 24:2162–2165
Ayral X, Pickering EH, Woodworth TG, Mackillop N, Dougados M (2005) Synovitis: a potential predictive factor of structural progression of medial tibiofemoral knee osteoarthritis e results of a 1 year longitudinal arthroscopic study in 422 patients. Osteoarthr Cartil 13:361–367
Eşen S, Akarırmak U, Aydın FY, Unalan H (2013) Clinical evaluation during the acute exacerbation of knee osteoarthritis: the impact of diagnostic ultrasonography. Rheumatol Int 33:711–717. doi:10.1007/s00296-012-2441-1
Altman R (1991) Classification of disease: osteoarthritis. Semin Arthritis Rheum 20(Suppl 2):40–47
Kellgren JH, Lawrence JS (1957) Radiological assessment of osteoarthritis. Ann Rheum Dis 16:499–502
Group for the Respect of Ethics and Excellence in Science (GREES) (1996) Osteoarthritis section recommendations for the registration of drugs used in the treatment of osteoarthritis. Ann Rheum Dis 55:552–557
Helfenstein M Jr, Kuromoto J (2010) Anserine syndrome. Rev Bras Reumatol 50:313–327
Rennie WJ, Saifuddin A (2005) Pes anserine bursitis: incidence in symptomatic knees and clinical presentation. Skelet Radiol 34:395–398
Kang I, Han SW (2000) Anserine bursitis in patients with osteoarthritis of the knee. South Med J 93:207–209
Yoon HS, Kim SE, Suh YR, Seo YI, Kim HA (2005) Correlation between ultrasonographic findings and the response to corticosteroid injection in pes anserinus tendinobursitis syndrome in knee osteoarthritis patients. J Korean Med Sci 20:109–112
Unlu Z, Ozmen B, Taethan S, Boyvoda S, Goktan C (2003) Ultrasonographic evaluation of pes anserinus tendino-bursitis in patients with type 2 diabetes mellitus. J Rheumatol 30:352–354
Disclosures
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Uysal, F., Akbal, A., Gökmen, F. et al. Prevalence of pes anserine bursitis in symptomatic osteoarthritis patients: an ultrasonographic prospective study. Clin Rheumatol 34, 529–533 (2015). https://doi.org/10.1007/s10067-014-2653-8
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-014-2653-8