Which finding would most strongly support pes anserine bursitis rather than PFPS?

Which finding would most strongly support pes anserine bursitis rather than PFPS?

• A. Tenderness along the medial tibia just inferior to the medial joint line
• B. Pain behind patella during squatting
• C. Pain with resisted knee extension
• D. Exaggerated dynamic knee valgus during step down

Answer: (B)

Distinguishing pes anserine bursitis from PFPS relies on where the pain and tenderness are located. Pes anserine bursitis produces focal pain and tenderness at the medial tibia where the pes anserinus inserts (just below the medial joint line). This medial-tibial tenderness is the strongest clue because the inflamed bursa sits there, so palpation over that medial proximal tibia is most telling. Pain behind the patella during squatting points toward PFPS, since deepening flexion compresses the patellofemoral joint and commonly causes anterior knee pain in this region. Pain with resisted knee extension likewise tends to implicate the extensor mechanism and patellofemoral joint involvement seen in PFPS rather than the pes anserine bursa. Exaggerated dynamic knee valgus during stepping down also favors PFPS, as this altered mechanics increases patellofemoral joint stress. So the strongest finding for pes anserine bursitis is tenderness on the medial tibia just below the medial joint line, reflecting the bursa’s location.

Distinguishing pes anserine bursitis from PFPS relies on where the pain and tenderness are located. Pes anserine bursitis produces focal pain and tenderness at the medial tibia where the pes anserinus inserts (just below the medial joint line). This medial-tibial tenderness is the strongest clue because the inflamed bursa sits there, so palpation over that medial proximal tibia is most telling.

Pain behind the patella during squatting points toward PFPS, since deepening flexion compresses the patellofemoral joint and commonly causes anterior knee pain in this region. Pain with resisted knee extension likewise tends to implicate the extensor mechanism and patellofemoral joint involvement seen in PFPS rather than the pes anserine bursa. Exaggerated dynamic knee valgus during stepping down also favors PFPS, as this altered mechanics increases patellofemoral joint stress.

So the strongest finding for pes anserine bursitis is tenderness on the medial tibia just below the medial joint line, reflecting the bursa’s location.