II. Epidemiology

  1. Incidence: Rare
  2. Most common in males, ages 25 to 40 years

III. Pathophysiology

  1. Medial collateral ligament (MCL) ossification (calcification)
  2. Results from valgus stress induced MCL injury
  3. Inflammatory response to injury leads to a delayed calcification at 2 to 6 weeks after injury

IV. Causes

  1. Acute MCL injury
  2. Repetitive MCL injury and overuse
  3. Overstretching

V. Symptoms

  1. Medial Knee Pain following injury

VI. Signs

  1. Medial knee tenderness
    1. Medial femoral condyle
    2. Proximal medial collateral ligament (MCL)
  2. Palpable firm localized swelling may be present
  3. Absent Knee Effusion
  4. Provocative
    1. Range of motion is painful (active and passive)
    2. Valgus stress test painful

VII. Imaging

  1. XRay Knee (preferred)
    1. Linear calcification at the medial aspect of the medial femoral condyle (Pellegrini-Stieda Sign)
    2. Distinguish from avulsion Fracture
  2. MRI Knee
    1. Not typically needed in Pellegrini-Stieda Lesion, unless unclear diagnosis with persistent symptoms
    2. MRI demonstrates MCL thickened

VIII. Differential Diagnosis

IX. Management

  1. Conservative management (preferred and effective)
    1. NSAIDs
    2. Physical therapy (esp. range of motion Exercises)
    3. Expect gradual healing over a 6 month course
  2. Surgical Excision of Calcifications
    1. Rarely indicated
    2. Surgery increases the risk of calcification recurrence as well as need for MCL reconstruction

X. Complications

  1. Restricted range of motion
  2. Joint Contractures
  3. Altered Gait

XI. Resources

XII. References

  1. Kiel (2024) Crit Dec Emerg Med 38(5): 16-7

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Related Studies

Ontology: Pellegrini-Stieda syndrome (C0263930)

Concepts Disease or Syndrome (T047)
ICD10 M76.4
SnomedCT 268089006, 156662006, 202869006, 60644007
English Tibial collateral bursitis [Pellegrini-Stieda], Calcific medl collat lig knee, Pellegrini - Stieda syndrome, Calcification of medial collateral ligament of knee, Pellegrini-Stieda syndrome, Pellegrini-Stieda syndrome (disorder), Pellegrini-Stieda
German Bursitis im Bereich des Lig. collaterale tibiale [Stieda-Pellegrini]
Korean 정강뼈 측부 윤활낭염[펠레그리니-스티다]
Dutch Bursitis van ligamentum collaterale tibiale [Pellegrini-Stieda]
Spanish calcificación del ligamento lateral medial de la rodilla, síndrome de Pellegrini - Stieda (trastorno), síndrome de Pellegrini - Stieda

Ontology: Pellegrini Stieda disease (C3665890)

Concepts Injury or Poisoning (T037)
English Pellegrini Stieda disease
Czech Stiedův-Pellegriniho syndrom
Dutch ziekte van Pellegrini-Stieda
French Maladie de Pellegrini Stieda
German Stieda-Pellegrini-Koehler-Schatten
Hungarian Pellegrini Stieda betegség
Italian Malattia di Pellegrini-Stieda
Japanese ペレグリーニ・シュティーダ病, ペレグリーニシュティーダビョウ
Portuguese Doença de Pellegrini-Stieda
Spanish Enfermedad de Pellegrini-Stieda