Skip to main content
Log in

Ultrasound-guided percutaneous lavage of calcific bursitis of the medial collateral ligament of the knee: a case report and review of the literature

  • Case Report
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objectives

Calcification of the medial collateral ligament (MCL) of the knee is rare. The literature reports no positive outcomes when conservative treatment has been followed. This paper reports a case of such calcification and its treatment using ultrasound-guided percutaneous lavage (UGPL).

Methods

A 66-year-old patient presented with medial knee pain. X-ray, ultrasound, and magnetic resonance (MR) examinations revealed calcific bursitis of the MCL, which was treated by UGPL.

Results

One month after treatment the patient was asymptomatic. X-ray, ultrasound, and MR examinations confirmed the almost complete disappearance of the calcification; only very tiny fragments remained.

Conclusions

Calcific bursitis of the MCL of the knee is very uncommon, but should be taken into account in differential diagnoses for medial knee pain. UGPL is proposed as a treatment for this condition.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Johar SK. Medial knee pain in a runner: a case report. Sports Health. 2010;2(4):318–20.

    PubMed  PubMed Central  Google Scholar 

  2. Saavedra MA, Navarro-Zarza JE, Villasenor-Ovies P, Canoso JJ, Vargas A, Chiapas-Gasca K, et al. Clinical anatomy of the knee. Reumatol Clin. 2012;8 Suppl 2:39–45.

    Article  PubMed  Google Scholar 

  3. Perdikakis E, Skiadas V. MRI characteristics of cysts and “cyst-like” lesions in and around the knee: what the radiologist needs to know. Insights Imag. 2013;4(3):257–72.

    Article  Google Scholar 

  4. Brantigan OC, Voshell AF. The tibial collateral ligament: its function, its bursae, and its relation to the medial meniscus. J Bone Joint Surg Am. 1943;25:121–31.

    Google Scholar 

  5. Kerlan RK, Glousman RE. Tibial collateral ligament bursitis. Am J Sports Med. 1988;16(4):344–6.

    Article  CAS  PubMed  Google Scholar 

  6. Lee JK, Yao L. Tibial collateral ligament bursa: MR imaging. Radiology. 1991;178(3):855–7.

    Article  CAS  PubMed  Google Scholar 

  7. De Maeseneer M, Shahabpour M, Van Roy F, Goossens A, De Ridder F, Clarijs J, et al. MR imaging of the medial collateral ligament bursa: findings in patients and anatomic data derived from cadavers. AJR Am J Roentgenol. 2001;177(4):911–7.

    Article  PubMed  Google Scholar 

  8. Stuttle FL. The no-name and no-fame bursa. Clin Orthop. 1959;15:197–9.

    CAS  PubMed  Google Scholar 

  9. Siegal DS, Wu JS, Newman JS, Del Cura JL, Hochman MG. Calcific tendinitis: a pictorial review. Can Assoc Radiol J. 2009;60(5):263–72.

    Article  PubMed  Google Scholar 

  10. Hayes CW, Rosenthal DI, Plata MJ, Hudson TM. Calcific tendinitis in unusual sites associated with cortical bone erosion. AJR Am J Roentgenol. 1987;149(5):967–70.

    Article  CAS  PubMed  Google Scholar 

  11. Muschol M, Muller I, Petersen W, Hassenpflug J. Symptomatic calcification of the medial collateral ligament of the knee joint: a report about five cases. Knee Surg Sports Traumatol Arthrosc. 2005;13(7):598–602.

    Article  PubMed  Google Scholar 

  12. Del Castillo-González F, Ramos-Álvarez J, Rodríguez-Fabian G, González-Pérez J, Calderón-Montero F. Treatment of calcifying tendinopathy of the rotator cuff by ultrasound-guided percutaneous needle lavage. two years prospective study. Muscles, Ligaments Tendons J. 2014;4(2):220–5.

    Google Scholar 

  13. Oliva F, Via AG, Maffulli N. Calcific tendinopathy of the rotator cuff tendons. Sports Med Arthrosc. 2011;19(3):237–43.

    Article  PubMed  Google Scholar 

  14. Williams BS, Cohen SP. Greater trochanteric pain syndrome: a review of anatomy, diagnosis and treatment. Anesth Analg. 2009;108(5):1662–70.

    Article  PubMed  Google Scholar 

  15. Keskin D. Fibular collateral ligament-biceps femoris calcific bursitis causing flexion contracture in the knee, external rotation in the leg, and equinus deformity in the ankle. J Manipulative Physiol Ther. 2008;31(3):247–50.

    Article  PubMed  Google Scholar 

  16. Lanza E, Banfi G, Serafini G, Lacelli F, Orlandi D, Bandirali M, et al. Ultrasound-guided percutaneous irrigation in rotator cuff calcific tendinopathy: what is the evidence? a systematic review with proposals for future reporting. Eur Radiol. 2015;25(7):2176–83.

    Article  PubMed  Google Scholar 

  17. Uhthoff H, Sarkar K, Maynard J. Calcifying tendinitis. Clin Orthop. 1976;118:164–8.

    PubMed  Google Scholar 

  18. Mendes LFA, Pretterklieber ML, Cho JH, García GM, Resnick DL, Chung CB. Pellegrini–Stieda disease: a heterogeneous disorder not synonymous with ossification/calcification of the tibial collateral ligament-anatomic and imaging investigation. Skeletal Radiol. 2006;35:916–22.

    Article  PubMed  Google Scholar 

  19. Eustace JA, Brophy DP, Gibney RP, Bresnihan B, FitzGerald O. Comparison of the accuracy of steroid placement with clinical outcome in patients with shoulder symptoms. Ann Rheum Dis. 1997;56(1):59–63.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Jose J, Schallert E, Lesniak B. Sonographically guided therapeutic injection for primary medial (tibial) collateral bursitis. J Ultrasound Med. 2011;30(2):257–61.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Juan José Ramos-Álvarez.

Ethics declarations

Informed consent

Informed consent was obtained from the participating patient. This article does not contain patient data.

Ethical approval

The procedure was performed in accordance with the ethical standards of the Universidad Complutense de Madrid, and in agreement with the Helsinki Declaration.

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Del Castillo-González, F., Ramos-Álvarez, J.J., González-Pérez, J. et al. Ultrasound-guided percutaneous lavage of calcific bursitis of the medial collateral ligament of the knee: a case report and review of the literature. Skeletal Radiol 45, 1419–1423 (2016). https://doi.org/10.1007/s00256-016-2442-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-016-2442-3

Keywords

Navigation