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Author Topic: Pes Anserinus  (Read 836 times)

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Offline hopa860

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Pes Anserinus
« on: August 20, 2009, 09:17:11 PM »
Hi all - my first post - just after some advice.

I will try to tell you my history comprehensively and then ask my questions towards the end so forgive the length of this post!

I started to experience knee pain about a year ago, especially when exercising and playing table tennis which I was starting to play at an increasingly higher level.  The pain started off very sharp in a concentrated area on the inside of my leg just below the knee.  This pain, although still sharp, quickly became permanent to the point that I could certainly not play sport as just walking hurt badly. I went to see a Physio whilst still at University who diagnosed a torn medial meniscus tear almost immediately by performing McMurray's test amongst other things. He referred me to my Hospital at home.

I then had an appointment with a physio at my Hospital at home who agreed with his diagnosis.  Although she was competent she seemed a little lacking in confidence so asked a knee specialist to come and have a look at me.  He agreed with the diagnosis of torn meniscus and so having the specialist pop in to see me obviously put my mind at ease.

I had an MRI scan in January 2009 which I was told showed a torn mensiscus and so agreed with the previous diagnosis. I was told my only option was to have a knee arthroscopy in which the cartilage would be trimmed or removed.  I chose to have the operation as soon as I finished University as that would give me 6 weeks to recover before going traveling (which I was told would be fine).

So I had the arthroscopy in mid-June. As soon as I woke up from the operation I was convinced it had not worked as I still had exactly the same pain in exactly the same place. Obviously I was told to give it the required 6 weeks to settle down but I knew it had not worked. The most frustrating thing was that after the operation the nurse informed me that all my cartilage was fine! The surgeon had however removed the plica and 'washed my knee out.'  I was fully load-bearing after the operation.

I attended physio to build my muscles back up and started to do my own research into my problem.  Whilst going to the gym I had discussions with two personal trainers who worryingly both asked me why I had had an operation on my knee when it appeared my pain was at the top of my tibia!!  I quickly came to the conclusion that my problem was either a stress fracture or Pes Anserinus.  I saw the Surgeon's Registrar 6 weeks after the operation and when I asked how my cartilage was fine when the MRI showed a tear he said; "The radiographer read the scan wrong." I quickly picked up on the word "wrong" and he back tracked to say that the shadows on the scan were confusing and showed something which was not there. It puzzled me that by his wording it sounded like the surgeon who actually carried out the surgery had not looked at the scan, just relied on the radiographers opinion.  I then continued to tell the Doctor about my own research. He ruled out a stress fracture straight away as this would be clear on the MRI. He agreed with my diagnosis of Pes Anserinus (swelling and discomfort of three tendons attaching to the tibia) but could only offer me ultrasound once a week or a cortisone injection.  I turned down the injection for the fact I know footballers that have been troubled in later life due to having them.

So at this point I was totally loosing my faith in the Surgeon and his team that had treated me. My traveling ambitions had gone totally out of the window.  The pain was intense in a specific point of my knee and far from returning to sport I sometimes find it difficult to even walk. Due to my frustration and willingness to try anything I decided to pay to see a Sports Doctor who is very well regarded in the football world. He was brilliant and also agreed with Pes Anserinus but informed me it was probably caused by me severe foot angle (due to breaking my leg at the age of 9) placing pressure on the inside of my leg. He recommended me to a Physio friend of his and talked about using trigger points etc. to try to right the problem.  When I asked him whether I had ever needed the knee arthroscospy he frowned and said he would be very interested to see the MRI scan, so I am in the process of applying to get the disk to send on to him.

As of today I have had one session with the physio and although feel no difference as of yet, I am hopefully now on the right road to recovery.

So, my questions are as follows: Does anybody think I have a case for clinical negligence due to incorrect diagnosis of my problem?  To myself (certainly not medically trained!) and the Doctor I paid to see it was painfully obvious my problem was not so much the knee but the top of my leg! I am not after money or any of that, I would simply want to know if I had been done wrong by and get my point across if that was the case. My traveling plans are long gone and I am worried I will be severely affected when I start work in late September as I will be walking round a building site for 10 hours a day and at the moment can manage 20 minutes!  Another annoying point is the fact that the operation it turns out I did not need has caused general niggles around my knee and painful clicking on the other side (was there any need to take out the plica??)

Does anyone have experience of Pes Anserinus and/or a cortisone injection to solve the problem? I am currently doing stretches (mainly hamstring) and icing it four times a day and receiving ultrasound. Is there anything else I can try?

And finally is there anything else anyone thinks it could be!? A lot of people I have spoken to express surprise at the amount of pain it cause me. Sometime it really is agony and I struggle to walk.

As you can appreciate I am very frustrated by my situation at the moment and it has been quite therapeutic to write it all down!  So if you have read this far I thank you for your time and any advice / opinions you can give me.

I will copy this into a couple of the other relevant forums (is that ok!?) as I would like as many opinions / answers as possible.

Thanks Again

Offline plantgeek58

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Re: Pes Anserinus
« Reply #1 on: August 22, 2009, 06:17:20 PM »
I've had pes anserinus bursitis as a side effect of a couple of my knee surgeries. My OS has always been able to clear it up with an injection, which usually takes effect within about 2 weeks. He says it's one of the easiest knee issues to solve. I'm not sure if it's cortisone that he uses, though. I don't remember what he told me when I asked.
RK 7/04 part. m. menisc., plica resect., MF
    3/05 part. m. menisc., open OATS
    1/07 part l. menisc., MF, patellar chondroplasty
    9/08 MF
LK 11/04 & 8/06 part m. menisc.
     7/07 LR, patellar tendon debrid., part m. menisc.