The article by Jack Taunton and Michael Wilkinson on anterior knee pain1 covered most conditions seen at sports medicine clinics but omitted one frequently misdiagnosed condition, anserine bursitis, which is rare in athletes.
It is easily recognized in overweight, middle-aged or elderly women with anterior knee pain and well-localized tenderness, sometimes with puffiness, about 5 cm below the knee joint on the medial portion of the anterior tibia.2 Osteoarthritis of the knee is often present and distracts from consideration of anserine bursitis. Local injection of corticosteroids gives good relief with confirmation of the diagnosis.3
Signature
Harold H. Fireman
Rheumatologist Ottawa, Ont.
References
- 1.Taunton JE, Wilkinson M. Rheumatology: 14. Diagnosis and management of anterior knee pain. CMAJ 2001;164(11):1595-601. [PMC free article] [PubMed]
- 2.Larsson LG, Baum J. The syndrome of anserine bursitis: an overlooked diagnosis. Arthritis Rheum 1985;28:1062-5. [DOI] [PubMed]
- 3.Klippel JH, Weyand CM, Wortman R, editors. Anserine bursitis. In: Primer on rheumatic diseases. 11th ed. Marietta (GA): Longstreet Press; 1998.