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Related Experiment Video

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Author Spotlight: Ultrasound-Guided Needle Release Combined with Corticosteroid Injection for the Treatment of Supinator Syndrome
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Snapping pes anserine syndrome.

Charles E Rainey1, Danielle A Taysom, Michael D Rosenthal

  • 1Naval Special Warfare Group ONE, San Diego, CA.

The Journal of Orthopaedic and Sports Physical Therapy
|January 2, 2014
PubMed
Summary

A painful snapping knee in a military service member was initially diagnosed as snapping pes anserine syndrome. Dynamic ultrasound revealed the cause was tendons sliding over a posteromedial knee mass.

Area of Science:

  • Orthopedics
  • Radiology
  • Sports Medicine

Background:

  • A 25-year-old military member presented with worsening posteromedial left knee pain and snapping.
  • Previous magnetic resonance imaging (MRI) showed only mild fluid around the pes anserine bursa, leading to a diagnosis of snapping pes anserine syndrome.
  • Standard physical therapy intervention for six weeks yielded no improvement.

Observation:

  • A dynamic real-time ultrasound examination was performed to further investigate the persistent symptoms.
  • The ultrasound visualized the pes anserine tendons' dynamic movement during knee flexion and extension.

Findings:

  • The examination revealed the pes anserine tendons were sliding over a heterogeneous rounded mass located in the posteromedial knee.
  • This finding suggests the mass was the source of the snapping and pain, rather than a primary bursitis.

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Implications:

  • Dynamic ultrasound is a valuable tool for diagnosing conditions causing snapping knee pain when initial imaging is inconclusive.
  • Accurate diagnosis through advanced imaging can guide targeted treatment, potentially avoiding prolonged, ineffective therapies.
  • This case highlights the importance of considering soft tissue masses as a cause of snapping knee phenomena.