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The pes anserine tendons comprise the sartorial, grassless and semitendinosus tendons named anterior to posterior. The three tendons become flattened and tape like as they approach their insertion below the medial joint line and below the tibial insertion of the medial collateral ligament. Their combined insertion resembles a ducks foot leading to the unusual name. Several bur sae are also present in this region, the most important is the per anserine bursa through which the semitendinosus passes before it inserts. Injuries to the per anserine insertion may be acute or chronic. Acute injuries usually result in tendon avulsion. There is considerable oedema surrounding the tendons and extending into the surrounding fat. More chronic injury usually manifests as per anserine bursitis. The detection of per anserine bursitis should prompt a search for other potential enthesopathy and bursitis.
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