Stieda Pellegrini Syndrome

Case
A 26-year-old male football player presents with well localised pain about the medial knee. The pain is related to activity and is associated with quite marked localised tenderness. He reported having sustained a medial collateral ligament injury to his knee five months previously. While he was able to return to football after this injury, he does not feel that the problem has ever completely resolved – and is now getting worse. The main finding on clinical examination was localised tenderness about the medial femoral condyle.

Findings
An AP x-ray image of the knee shows a small curvilinear ossification adjacent to the medial femoral condyle. This was not present on an x-ray taken at the time of his initial injury. No other abnormality is seen.

Discussion
This player was diagnosed with Pellegrini-Stieda syndrome. After a discussion about the treatment options he elected to have a steroid injection. This was administered about the area of calcification at the medial femoral condyle. He responded well to this and remains symptom-free six months later.

Pellegrini-Stieda syndrome should be suspected when patients continue to have pain following an otherwise uncomplicated medial collateral ligament injury. It can generally be diagnosed on x-ray however MRI may have a role. MR imaging can show the ossicle or enthesophyte at the medial femoral condyle and would generally show increased signal and thickening of the medial collateral ligament. I can also demonstrate other possible causes of medial knee pain.

In many cases the calcification is not associated with any symptoms. When it is symptomatic however there are a number of treatment options. Local treatments (like ice, topical ant-inflammatories and massage) can be effective. Steroid injections can help improve pain while some patients need to have surgical exploration, excision of the abnormal tissue and/or repair of the medial collateral ligament. In general the prognosis is good.

Important notice
FIFA does not bear any responsibility for the accuracy and completeness of any information provided in the “Radiology Review” features and cannot be held liable with regard to the information provided or any acts or omissions occurring on the basis of this information.

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Kareem Ayman Mamdouh HafezMark FulcherSteven Griffith Recent comment authors
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stevengriffith
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We use to call these case studies. Correct In being symptom free with the cortisone injection for six months, rarely to 18 months. I have found the calcification change accelerate while in the drug induced pain free state and when pain returns their is palpabable deformity at the site. This is the short end of the long road of cortisone cremes and analgesic rubs we witness. The areas become fibrotic and over the years and decades the leg looks Iike a naemotode knarl on a tree, a visible fixed lump then the patient develops a percular run to adapt. At… Read more »

Mark Fulcher
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This is indeed a case study – as are all of the radiology reviews. The general idea is to present interesting radiological findings and to present a discussion about the treatment of that case. The goal then is to foster discussion (so your post is great). Do you have any evidence for your position (that they all become worse over time)? I am not aware of any. As a result we rely on case studies and case series. My own experience has been different from yours. I think for most people the symptoms (short-term) generally spontaneously resolve without any specific… Read more »

Kareem Ayman Mamdouh Hafez
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Okay 👌🏻

Bangoura
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SURGERY OR RÉHABILITATION FOR RUPTURED ACHILLES TENDONS? VHICH IS BEST?
A mon avis une rupture aiguë du tendon d achilledoit être gérée chirurgicalement si l on veux avoir un bon resultat surtout avec les sportifs de haut niveau. Le traitement médical laisse toujours des cicatrices vicieuses avec possibilité de rerupture.
Les causes FAVORISANTES
1. Utilisation prolongée des corticoïdes
2utulisatio des terrains trop durs pour les athlètes de fond. Demi fond et footballeurs

Bangoura
Guest

STIEDA PELLIGRINI SYNDROME
Le syndrome de PELLIGRINI stries est une massification de la partie supérieure du ligament collatéral trivial du genou. Lorsque les premiers soins échouent le traitement chirurgical s impose en une excision du fragment osseux avec réparation du ligament collatéral interne. Le ligament collatéral interne est le principal stabilisateur en valgus de l articulation tibia.femorale. En cas de de reconstitution du ligament croisé antérieur il faut avoir à l esprit car la plus part des atteintes du LAC entraîne une atteinte probable du ligament collatéral interne

Bangoura
Guest

Stries et non stries
Massification et non massification

Bangoura
Guest

STIEDA
Ossification