Pes Anserinus Syndrome Caused by Osteochondroma in Paediatrics: A Case Series Study

Abstract

Introduction:Osteochondroma is a common benign bone tumor, protruding from the underlying normal bone. Osteochondromas can cause pain depending on their location and size. The pes anserinus is located at the proximal medial side of the tibia, where the tendinous insertions of the sartorius, gracilis and semitendinosus muscles collectively attach. Pes anserinus syndrome, or anserine bursitis, is a painful condition of the pes anserinus, and is more common in adults typically with overweight females. The occurrence of pes anserinus syndrome is rare in the paediatric population.Results:In the current case series, five patients with pes anserinus syndrome due to proximal tibial osteochondroma are reported. Pain was present in all cases, with snapping in one case. The average age of the patients was 13 ± 1.2 years, ranging from 12 to 15 years. Three patients had a single osteochondroma, and two patients had hereditary multiple exostoses. The sizes of the osteochondromas on plain radiographs varied from 0.5 to 2.5 cm, with an average of 1.46 ± 0.83 cm. All lesions characteristically were located at the medial-posterior edge of the proximal tibia. The symptoms resolved in four cases with surgical resection, and persisted in one non-resected patient.Conclusion:The characteristic location of the osteochondroma causes pes anserinus syndrome, even though the lesion is small. The diagnosis of osteochondroma or pes anserinus syndrome may be overlooked when it occurs in a paediatric population. The symptoms seem to be consistent, and resection of the osteochondroma is necessary for treatment.

Diaphyseal Aclasis With Pes Anserinus Syndrome

“…The spectrum of symptoms in patients with multiple osteochondromas includes limb length discrepancies and limb deformities, spine problems like nerve compression and scoliosis, persistent pains, and various compressive symptoms over adjoining tissues [10]. Impingement of the pes anserinus tendons and impingement over pes anserinus tendons by proximal tibial osteochondromas have been reported in children, and are mostly associated with solitary osteochondromas [4][5][6]. This report describes the pictorial pathoanatomy of a relatively rare association of pes anserinus syndrome caused by osteochondroma in an adult patient with diaphyseal aclasis.…”

“…Of the two cases, one was treated with surgical excision with good results. The other had persistent symptoms with conservative management [ 4 ]. Tiwari et al also described pes anserine bursitis in three pediatric cases with proximal tibial osteochondroma.…”

“…Most such tumors develop around the knee either from the distal femur or proximal tibia [3]. Rarely, proximal tibial osteochondromas can compress the adjoining pes anserinus tendons and cause a constellation of symptoms collectively described as pes anserinus syndrome [4][5][6]. Though pes anserinus syndrome has been rarely reported with solitary osteochondromas in children, its association with diaphyseal aclasis is even rarer [4].…”

“…Rarely, proximal tibial osteochondromas can compress the adjoining pes anserinus tendons and cause a constellation of symptoms collectively described as pes anserinus syndrome [4][5][6]. Though pes anserinus syndrome has been rarely reported with solitary osteochondromas in children, its association with diaphyseal aclasis is even rarer [4]. Moreover, a clear pictorial description of such association in adult patients is sparsely reported in the medical literature.…”

Suprapatellar bursitis in a newborn

“…Из всего спектра патологий костно-мышечной системы у детей бурситы коленного сустава представляют особый интерес ввиду своего клинического разнообразия [1][2][3]. Воспаления гнойного характера наиболее типичны для препателлярных бурситов [4][5][6].…”