Presentation
Pain in the right knee. No recent trauma.
Patient Data
Adjacent to the medial femoral condyle at the region of the adductor tubercle there is a linear ossification parallel to the femoral cortex. The femoral cortex is well corticated without any acute features.
Mild loss of joint space with osteophyte formation at the patellofemoral and tibiofibular joint space is noted. A small traction enthesophyte is noted at the quadriceps insertion of the patella. The medial and lateral compartments of the knee are well maintained.
The bone density is adequate without evidence of acute fracture or gross osseous destruction.
Soft tissues about the knee are well maintained.
Case Discussion
Pellegrini-Stieda lesions represent ossification of the proximal insertional fibers of the medial collateral ligament. The ossification is a result of a prior insult (often a valgus stress) which causes damage, inflammation, and concomitant ossification of the ligamentous fibers. It is not a result of an avulsion injury.
When the extent of ossification is mild to moderate (as in this case) more conservative management is often rewarding. More advanced cases, that are unresponsive to physical rehabilitation, can be referred for a surgical consultation although surgical outcomes are somewhat guarded.
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