Radiology Review

Woman Complains of Knee Pain Following Fight

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A 35-year-old woman presents for evaluation of left knee pain secondary to an assault. She says she was involved in a fight and was struck multiple times throughout her whole body. She states she is “sore all over,” but her knee bothers her the most, as it is difficult and painful to bear weight. The patient’s medical history is unremarkable. Physical exam shows a young female who is uncomfortable but in no obvious distress. Her vital signs are normal. You note bruises throughout her body. Inspection of her left knee shows no obvious deformity or swelling. There is some mild bruising and pain present to palpation. She has limited flexion and extension secondary to pain. However, the joint itself appears stable. Radiographs of the knee are obtained. What is your impression?


 

References

ANSWER
The radiograph shows a small calcifi­cation along the medial aspect of the medial collateral ligament. This finding is known as a Pellegrini-Stieda lesion. While it certainly could represent a small avulsion fracture, the lack of joint fluid and soft-tissue swelling makes this diagnosis less likely. The patient was treated symptomatically with anti-inflammatory medications.

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