A patient with medial knee pain during functional activities MOST likely has which condition?

• A. Pes anserine bursitis
• B. Tibial apophysitis
• C. Iliotibial band syndrome
• D. Baker's cyst

Answer: (A)

Pain on the medial side of the knee, especially just below the joint line, that flares with weight-bearing activities and kneeling points to pes anserine bursitis. The pes anserine bursa sits under the tendons of the sartorius, gracilis, and semitendinosus at the medial proximal tibia. Overuse or repetitive valgus stress can irritate this bursa, producing focal tenderness and medial knee pain with activity.

This differs from tibial apophysitis, which is an adolescence-related avulsion at the tibial tubercle with pain centered there; iliotibial band syndrome causes lateral knee pain near the lateral femoral epicondyle, usually with running; and Baker’s cyst involves posterior knee swelling or tightness behind the knee rather than true medial joint-line pain.