Medial Collateral Ligament Calcification, Presenting as Knee Pain. An unusual Case Report
Antao N et al. - Medial Collateral Ligament Calcification, Presenting as Knee Pain.

Keywords

MCL
Calcification
Knee Pain

How to Cite

Antao, N., & Desouza, C. (2023). Medial Collateral Ligament Calcification, Presenting as Knee Pain. An unusual Case Report. Albanian Journal of Trauma and Emergency Surgery, 7(1), 1200-1204. https://doi.org/10.32391/ajtes.v7i1.294

Abstract

Background: The tibial collateral ligament, also known as the medial collateral ligament (MCL), is a ligament extending from the medial epicondyle of the femur to the posteromedial crest of the tibia. The ligament is a broad and strong band that mainly functions to stabilize the knee joint in the coronal plane on the medial side Since MCL calcification is not a frequent knee pain manifestation, exclusion of other confusing clinical mimicries is of paramount importance. Here, in this report, we describe a well-circumscribed calcific deposit in the left femoral condylar attachment of MCL reported very rarely in the medical literature. 

Case Report: A 37-year-old laborer presented to the Outpatient department with pain and flexion deformity of the Right knee for 6 months. He walked on a flexed knee with a limping gait.  A plain radiograph of the right was taken in AP and Lateral view which showed a massive well-defined calcification at the medial side of the knee joint. Considering the large size of the lesion, surgical treatment was chosen. Intra-operatively, as the MCL was involved a reconstruction was done using the semitendinosus tendon.

Conclusion: Chronic pain located at the medial side of the knee is not always osteoarthritic pain. Thorough clinical and radiological investigation with plain radiographs and MRI in some cases is mandatory. Calcification or ossification of the medial collateral ligament of the knee responds well to conservative treatment. Surgical resection is needed in some cases with larger lesions.

https://doi.org/10.32391/ajtes.v7i1.294
Antao N et al. - Medial Collateral Ligament Calcification, Presenting as Knee Pain.

References

References

Bourne M, Sinkler MA, Murphy PB. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Aug 11, 2021. Anatomy, Bony Pelvis and Lower Limb, Tibia.

Gupton M, Imonugo O, Terreberry RR. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Mar 6, 2021. Anatomy, Bony Pelvis and Lower Limb, Knee.

Liu F, Yue B, Gadikota HR, et al. Morphology of the medial collateral ligament of the knee. J Orthop Surg Res 2010; 5: 69–69.

Sprouse RA, McLaughlin AM, Harris GD. Braces and Splints for Common Musculoskeletal Conditions. Am Fam Physician. 2018 Nov 15;98(10):570-576.

Tadlock BA, Pierpoint LA, Covassin T, Caswell SV, Lincoln AE, Kerr ZY. Epidemiology of knee internal derangement injuries in United States high school girls' lacrosse, 2008/09-2016/17 academic years. Res Sports Med. 2019 Oct-Dec;27(4):497-508.

LaPrade RF, Moulton SG, Nitri M, et al. Clinically relevant anatomy and what anatomic reconstruction means. Knee Surg Sports Traumatol Arthrosc 2015; 23: 2950–2959.

Phisitkul P, James SL, Wolf BR, et al. MCL injuries of the knee: current concepts review. Iowa Orthop J 2006; 26: 77–90.

Chang WC, Huang GS, Lee CH, et al. Calcification of medial collateral ligament of the knee: an uncommon cause of medial knee pain. J Clin Rheumatol 2006; 12: 204–205.

Muschol M, Muller I, Petersen W, et al. Symptomatic calcification of the medial collateral ligament of the knee joint: a report about five cases. Knee Surg Sports Traumatol Arthrosc 2005; 13: 598–602.

Calmbach WL, Hutchens M. Evaluation of patients presenting with knee pain: part II. Differential diagnosis. Am Fam Physician 2003; 68: 917–922.

Helfenstein M, Jr, Kuromoto J. Anserine syndrome. Bras J Rheumatol 2010; 50: 313–327.

Kamawal Y, Steinert AF, Barthel T. Case report – calcification of the medial collateral ligament of the knee with simultaneous calciifying tendinitis of the rotator cuff. BMC Musculoskelet Disord 2016; 17: 283–283.

Steewart VL, Herling P, Dalinka MK. Calcification in soft tissues. JAMA 1983; 250: 78–81.

Gokcen N, Kelle B, Kozanoglu E. Intraligamentous Calcification of the medial collateral ligament mimicking Pellegrini-Stieda syndrome in a lower-extremity amputee. Turk J Phys Med Rehab 2015; 61: 70–72.

Vampertzis T, Agathangelidis F, Gkouliopoulou E, et al. Massive non-traumatic calcification of the medial collateral ligament of the knee. BMJ Case Rep 2016; 23: 2016–2016.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.