Anserine bursa injection is a useful diagnostic and therapeutic procedure in bursitis resulting from osteoarthritis or direct trauma. Pain is noted inferior to the anterior medial surface of the knee when climbing stairs. Pain is reproduced with the knee in flexion-extension while internally rotating the leg.
After informed consent is obtained, the patient is placed in the supine position with the knee in extension. The knee is palpated for the point of maximal tenderness over the medial tibial flare. The patient is prepared in a standard aseptic fashion over an area large enough to allow palpation of landmarks, and sterile technique is used throughout the procedure. A 1½-in. (4-cm), 21-gauge needle is inserted perpendicular to the skin and at the point of maximal tenderness. The needle is advanced to the periosteum and withdrawn slightly. After negative aspiration, a 4-mL mixture of 2 mg of triamcinolone acetonide (or equivalent) and local anesthetic is injected (Fig. 67-54).
FIGURE 67-54. Anserine bursa injection. Approach for anserine bursa aspiration and injection.
The anserine bursa is one of the most common bursae to become inflamed in the lower extremity. Kneepads are recommended for athletes with anserine bursitis secondary to trauma.
Serious complications are uncommon with injection of the anserine bursa.