(Kiosk 2) Ultrasound and MRI Appearance of Medial Collateral Ligament Calcific Bursitis: An Uncommon Cause of Medial Knee Pain

Case Diagnosis: Medial Collateral Ligament Calcific Bursitis

Case Description or Program Description: A 72-year-old male presented to outpatient clinic with complaint of chronic medial knee pain, worse with prolonged sitting or walking and relieved with rest and anti-inflammatories. Physical exam was consistent with tenderness over proximal MCL and pain with valgus stress. X-ray and MRI findings were consistent with mild medial and patellofemoral osteoarthritis with preserved menisci, a thickened MCL and a Pellegrini Steida lesion. Patient underwent intra-articular cortisone injection and subsequent viscosupplementation without relief. Diagnostic ultrasound of the medial right knee demonstrated fluid and calcification within the MCL bursa with concordant tenderness to palpation of this area. Patient underwent ultrasound guided steroid injection to calcified MCL bursa with 100% pain relief.

Setting: Outpatient Clinic

Assessment/Results: (X-ray, MRI, Ultrasound findings to be included in poster)

Discussion (relevance): Calcific bursitis of the MCL is a relatively rare condition that can present similarly to osteoarthritis (OA) and should be considered in patients who present with medial knee pain unresponsive to conservative OA treatments and with imaging findings suggestive of MCL pathology. Ultrasound offers a dynamic and low-cost way to evaluate patients clinically and may help with diagnosis. While anti-inflammatories, ice, and physical therapy are mainstay treatments, some patients may require more advanced interventions such as steroid injection or ultrasound guided percutaneous lavage.

Conclusions: We present a case of calcific MCL bursitis responsive to ultrasound guided corticosteroid injection. This diagnosis should be considered in patients presenting with medial knee pain unresponsive to standard OA treatment.