Ultrasound-guided percutaneous lavage of calcific bursitis of the medial collateral ligament of the knee: a case report and review of the literature
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.
Keywords
Calcific bursitis Medial collateral ligament Ultrasound Percutaneous lavageNotes
Compliance with ethical standards
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.
References
- 1.Johar SK. Medial knee pain in a runner: a case report. Sports Health. 2010;2(4):318–20.PubMedPubMedCentralGoogle 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.CrossRefPubMedGoogle 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.CrossRefGoogle 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.CrossRefPubMedGoogle Scholar
- 6.Lee JK, Yao L. Tibial collateral ligament bursa: MR imaging. Radiology. 1991;178(3):855–7.CrossRefPubMedGoogle 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.CrossRefPubMedGoogle Scholar
- 8.Stuttle FL. The no-name and no-fame bursa. Clin Orthop. 1959;15:197–9.PubMedGoogle 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.CrossRefPubMedGoogle 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.CrossRefPubMedGoogle 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.CrossRefPubMedGoogle 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.CrossRefPubMedGoogle Scholar
- 14.Williams BS, Cohen SP. Greater trochanteric pain syndrome: a review of anatomy, diagnosis and treatment. Anesth Analg. 2009;108(5):1662–70.CrossRefPubMedGoogle 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.CrossRefPubMedGoogle 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.CrossRefPubMedGoogle Scholar
- 17.Uhthoff H, Sarkar K, Maynard J. Calcifying tendinitis. Clin Orthop. 1976;118:164–8.PubMedGoogle 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.CrossRefPubMedGoogle 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.CrossRefPubMedPubMedCentralGoogle 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.PubMedGoogle Scholar