Snapping Pes Anserinus and the Diagnostic Utility of Dynamic Ultrasound

Abstract

Snapping pes anserinus syndrome is an often encountered cause of medial knee snapping. It results from impingement and translation of the gracilis tendon or semitendinosus tendon over the osseous structures of the knee during active flexion and extension. Ultrasonography is often the diagnostic imaging test of choice in cases of mechanical snapping. We report 2 cases of painful snapping pes anserinus and highlight the value of dynamic ultrasound in making an accurate diagnosis so as to direct care.

Snapping Pes Syndrome Caused by the Gracilis Tendon: Successful Selective Surgery with Specific Diagnosis by Ultrasonography

“…Second, releasing only the distal attachment of the tendon solved the symptom of SPS. Treatment for SPS usually consists of tenotomy with or without partial resection of both 3 Case Reports in Orthopedics gracilis and semitendinosus tendons [5,7,8,13] (Table 1). In these reports, the unnecessary tendon may have been resected because the responsible structure was not specifically identified.…”

“…Ultrasonography (US) is a useful diagnostic tool [5][6][7][8], because snapping occurs during joint motion, and only US can visualize the snapping dynamically. However, despite evaluating snapping dynamically with US, both semitendinosus and gracilis tendons were resected or harvested without clarifying which is the true cause in almost all reports.…”

Percutaneous Lengthening of a Regenerated Semitendinosus Tendon for Medial Hamstring Snapping

“… 1 Dynamic ultrasonography may be a useful tool in the diagnosis of medial hamstring snapping. 1 , 3 , 6 , 7 , 10 , 11 , 12 , 13 …”

“…Because of the paucity of scientific data on this phenomenon, the etiology of such symptoms is often undetermined, 8 and surgical procedures for treating this condition are variable. 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 13 , 14 …”

“…Because the snapping phenomenon occurs during movement, dynamic imaging may be superior for diagnostic confirmation and identification of the structure responsible for a patient's symptoms 1 . Dynamic ultrasonography may be a useful tool in the diagnosis of medial hamstring snapping 1, 3, 6, 7, 10, 11, 12, 13…”