Have you been told that you have arthritis because you experience knee pain? Is the pain on the side of your knee rather than within the knee joint? If so, you may actually have pes anserine bursitis or medial or lateral collateral tendinits.
The knee joint, which links the thigh and shinbone, is stabilized by strong cords called tendons. Strategically placed to prevent the knee from moving side to side, the medial collateral tendon is located on the inner side of the knee to prevent it from collapsing inward, and the lateral collateral tendon, on the outer side, to prevent outward twisting. The pes anserine bursa, a sac-like, protective cushion, is located beneath the tendons on the inner side of the knee.
Medial collateral tendinits usually occurs as a result of trauma associated with falls such as skiing or football injuries. Lateral collateral tendinits happens less frequently and heals more easily because it is less vulnerable to injury due to its location on the outer side of the knee. When direct trauma, overuse or misuse occurs, not only can the tendons become injured but the bursa can also become inflamed and irritated, meaning bursitis.
Long-distance runners commonly develop pes anserine bursitis because of stress placed on the knees. Misalignment of the lower extremities due to osteoarthritis can stress knee tendons and bursas causing tendinits and bursitis.
The most common complaint with medial collateral tendinits and pes anserine bursitis is constant aching of the inner side of the knee with increased pain on rotation of the knee. Activity, especially flexion and external rotation of the knee, increases pain, while resting and heat relieves it. Often, patients wake up at night due to pain and are unable to kneel or walk down stairs. Physical examination may reveal tenderness along with pain upon flexion and rotation.
Treatments for these conditions are similar, but are obviously location specific: analgesics, nonsteroidal anti-inflammatory drugs, use of a knee brace to prevent reinjury, physical therapy and heat application. Local cortisone injections at the affected site (anserine bursa or medial or lateral collateral tendon) are crucial to decrease inflammation for a successful outcome.
As in many circumstances, other conditions can show similar symptoms that must be differentiated prior to beginning treatment. Knee pain can be caused by arthritis, tendinits, bursitis or meniscus tear. The coexistence of knee osteoarthritis and tendinits, bursitis or meniscus tear is quite common, particularly in the elderly, which makes diagnosis much more difficult.
Don't just accept the answer that "You're getting older and you have arthritis." Know what the important differences are, and get the treatment you need and deserve.
Dr. Yong H. Tsai is board-certified in rheumatology, allergy and clinical immunology and has been practicing in this area since 1993. Send questions to Dr. Tsai in care of email@example.com. You also can check his website: arthritis-allergy.net.