Treatment of a calcific bursitis of the medial collateral ligament: a rare cause of painful knee

Galletti, Lisa; Ricci, Vincenzo; Andreoli, Ernesto; Galletti, Stefano

doi:10.1007/s40477-018-0353-y

Cited by 15 publications

(7 citation statements)

References 29 publications

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“…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].…”

Section: Appearance: Locationmentioning

confidence: 99%

“…There are limited treatment options described for the management of chronic MCL pain, and refractory pain may require surgical management. Open excision of PS ossific lesions can be challenging [17], and there is limited data for managing refractory MCL calcifications with arthroscopic resection or ultrasound-guided percutaneous lavage [20,23,[25][26][27]. Percutaneous treatment of calcific tendinopathy is not a new concept with the procedure being performed with fluoroscopic guidance since the 1970s [31] and with ultrasound guidance since the 1990s [32].…”

Section: Appearance: Locationmentioning

confidence: 99%

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

Sung¹,

Raja²,

Tunis³

et al. 2023

Cureus

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Chronic injury to the medial collateral ligament (MCL) is common following an acute knee injury. This case report presents two patients that failed to respond to conservative treatment with clinical evidence of an MCL injury and radiographic finding of a benign-appearing soft tissue lesion in the MCL. Calcified or ossified lesions have been described with chronic MCL injuries. Ossification and calcification of the MCL have been observed as potential causes of chronic MCL pain. Here, we detail the distinction between these two distinct intra-ligamentous heterotopic deposits and describe a novel treatment approach using ultrasonic percutaneous debridement, a technique that is typically reserved for tendinopathies. In both cases, pain improved, and they were able to return to their prior level of function.

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Section: Appearance: Locationmentioning

confidence: 99%

Section: Appearance: Locationmentioning

confidence: 99%

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

Sung¹,

Raja²,

Tunis³

et al. 2023

Cureus

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“…We strongly suggest performing a local sono-palpation over the bone irregularity in the attempt to exactly reproduce the pain usually complained by the patient [ 58 ]. Indeed, the aforementioned simple maneuver can be useful in clinical practice to optimize the differential diagnosis between pathological bony abnormalities and normal findings [ 59 ].…”

Section: Tips and Tricksmentioning

confidence: 99%

Ultrasound imaging of bone fractures

et al. 2022

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Ultrasound imaging is widely used to evaluate the neuromusculoskeletal system, and recently, a particular interest is mounting in assessing the bone tissue and fractures. Ultrasound can be considered a valuable diagnostic tool to perform a first-line evaluation of bone tissue, especially in particular settings without direct access to X-ray imaging and/or in emergency conditions. Moreover, different healing phases of bone fractures can be accurately assessed by combining the B-mode modality and (high-sensitive) color/power Doppler optimizing the management of patients—e.g., planning of progressive loads and rehabilitation procedures. In this review, we summarized the role of ultrasound imaging in the management of bone fractures and described the most common sonographic signs encountered in the daily practice by assessing different types of bone fractures and the progressive phases of the healing process.

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“…If clinically indicated, the synovial bursa can be injected under US guidance (Coll et al, 2022; Jose et al, 2011; Ricci et al, 2020; 39: 805–810). Of note, as for all the other bursae, several sonographic features can be observed inside the bursal effusion e.g., synovial hypertrophy and migration of calcific deposits inside the cavity (Del Castillo‐González et al, 2016; Galletti et al, 2019).…”

Section: Sonographic Examinationmentioning

confidence: 99%

Anatomy and ultrasound imaging of the tibial collateral ligament: A narrative review

et al. 2022

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Medial knee pain is commonplace in clinical practice and ultrasound assessment of the tibial collateral ligament-medial meniscus complex is increasingly becoming a valuable examination tool in the outpatient setting. In the pertinent literature, basic sonographic protocols have been proposed to evaluate the medial compartment of the knee joint. Using high-frequency ultrasound probes and high-level ultrasound machines; we matched the histo-anatomical features of the tibial collateral ligamentmedial meniscus complex and its different sonographic patterns in physiological/ pathological conditions to define a standardized (layer-by-layer) sonographic approach. Moreover, high-sensitive power Doppler assessments have also been performed to evaluate the nearby microcirculation. Modern ultrasound equipment appears to provide optimal "sonographic dissection" of the tibial collateral ligamentmedial meniscus complex for its various physiological/pathological patterns. Likewise, high-sensitive power Doppler allows clear visualization of the microcirculation as regards the local ligamentous and capsular structures. In clinical practice, using adequate technological equipment, a detailed sonographic assessment of the tibial collateral ligament-medial meniscus complex can be performed. High-frequency B-mode ultrasound imaging and high-sensitive power Doppler perfusion patterns can be matched/integrated with the clinical findings to optimize the management of patients with medial knee pain.

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Treatment of a calcific bursitis of the medial collateral ligament: a rare cause of painful knee

Cited by 15 publications

References 29 publications

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

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

Ultrasound imaging of bone fractures

Anatomy and ultrasound imaging of the tibial collateral ligament: A narrative review

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