Medial collateral ligament calcification: a rare knee pain entity with literature review

Abstract

Medial knee pain can originate from both osseous and non-osseous soft tissue structures including medial collateral ligament (MCL), creating a raft for patients’ sufferings. Previously published works demonstrated MCL calcification as a rare medial knee pain entity. Alongside physical examination, radio-imaging techniques, namely conventional X-ray, CT/MRI scanning, etc. have been reported to be useful in recognizing MCL calcification. The present study demonstrates MCL calcification in a 60-year-old Asian-Bangladeshi woman, using high frequency diagnostic ultrasonogram and is the first reported study in the literature. To have available literature review, PubMed, Cochrane, Embase, and Scopus databases were used.

Rehabilitation Medicine in Pellegrini-Stieda Syndrome with Myositis Ossificans and Neglected Patella Fracture

“…We knew that patellar fracture mechanism in traumatic case may caused by direct blow such as fall on flexed knee which caused high axial loading on knee compartment with valgus or varus stress. 1,12 We concluded from this injury mechanisms are the causative problem to developed this condition in this case report. The rehabilitation program in this patient are consist of two major aspects, first is the hospital based medical rehabilitation, the second is home programs.…”

“…Pellegrini-Stieda Syndrome is the proximal calcification of the medial collateral ligament of the knee, after a direct or indirect trauma thereof, causing valgus stress with disruption of the MCL fibers 9. The radiological findings plus the clinical symptomatology of pain and restriction in the ranges of motion are known under the name of PSS 1,6. Diagnosis is established from anamnesis, general inspection, and measurements such as palpation, range of motion (ROM) examination, gait, radiological imaging using X-ray, and for the further details there should be MRI imaging diagnostic applied to this patient.…”

Heterotopic Mineralization of the Medial Collateral Ligament: Our Experience Treating Two Cases of Calcific Versus Ossific Lesions With Ultrasonic Vacuum Debridement

“…Corticosteroid injections and shockwave therapy have been described as treatment modalities [ 21 ]. Radiographically, hydroxyapatite calcifications can be indistinguishable from detached PS lesions (type II, III or IV lesions), but hydroxyapatite calcifications are a distinct clinical entity and should be differentiated from PS lesions as their pathophysiology likely differs [ 22 , 23 ]. Soft tissue calcifications and ossifications are usually detected with plane films but have a similar radiopaque appearance.…”

“…Type 1 "beak-like" Extends into the MCL Type 2 "tear-drop" Localizes within the MCL, but detached from the femoral condyle Type 3 "elongated" Above femur within the adductor magnus tendon Type 4 "beak-like" Extends into the MCL and adductor magnus tendon Hydroxyapatite calcifications of the MCL are uncommon, and to the authors' knowledge, only 11 case reports have described calcification of the MCL [16,[20][21][22][23][24][25][26][27][28][29]. Calcifications are thought to be caused by soft tissue hypoxia leading to fibrocartilaginous metaplasia, cellular necrosis, and deposition of hydroxyapatite crystals [20].…”