Don't forget anserine bursitis
==============================

* Jack E. Taunton

Harold Fireman makes a good point regarding pes anserine bursitis in his letter concerning our article.1 We see this condition in hurdlers, steeplechasers and people who run downhill. If it persists you need to consider a traction stress fracture at the site and order a bone scan. If the bone scan is very hot then you will need a CT scan, as I have seen a few of these go to a completed fracture. For the true bursitis, local injection certainly can be effective and I have had good results with topical 10% diclofenac. The patient needs to work on hamstring stretching and quadriceps–hamstring strengthening.

## Reference

1.  1. Taunton JE, Wilkinson M. Rheumatology: 14. Diagnosis and management of anterior knee pain. CMAJ 2001;164(11):1595-601.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czoxMToiMTY0LzExLzE1OTUiO3M6NDoiYXRvbSI7czoyNDoiL2NtYWovMTY1LzEwLzEzMDAuNC5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=)