American Board of Internal Medicine (ABIM) Certification Practice Exam

How should Pes anserine bursitis be managed initially?

1. Glucocorticoid injections

2. Anti-inflammatory medications and ice application

3. Immediate physical therapy

4. Rest and elevation only

The correct answer is: Anti-inflammatory medications and ice application

Pes anserine bursitis, characterized by inflammation of the bursa located between the tibia and the tendons of the sartorius, gracilis, and semitendinosus muscles, is typically managed initially with non-invasive techniques. The preferred approach includes anti-inflammatory medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), to reduce pain and inflammation. Ice application is also essential in the acute phase, as it can help to decrease swelling and numb the area to alleviate discomfort. This initial management strategy focuses on symptom relief while minimizing any potential adverse effects associated with more invasive treatments. By using anti-inflammatory medications and ice, patients can often see improvements in their symptoms without the need for more aggressive interventions, such as glucocorticoid injections or physical therapy. Immediate physical therapy might not be indicated at the onset due to the need for rest in an acutely inflamed state. While rest and elevation can play a role in the overall management strategy, anti-inflammatory medications and ice application provide a more proactive and effective initial treatment plan for alleviating symptoms and addressing inflammation in pes anserine bursitis.