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A
43-year old male presents a chief complaint of
knee pain, stating pain in left knee only occurs when
walking or knee is overextended. Pain is occasionally
nagging, located primarily in upper mid-knee area. Pain
has existed only for the past six months, having started
immediately after a sudden twist of knee as patient
descended a ladder. Patient relates he never experienced
knee pain (or even twinge) in knee since skiing accident
nearly 20 years previously when he recalls a “nice jump
gone bad” -- apparent outward push of left foot in wrong
direction, forcing left knee to twist.
This happened to him on the slopes
and he had to be taken to the local Orthopedic Surgeon
by means of a stretcher, who made the diagnoses of
partial medial
collateral ligament tear and
recommended RICE (Rest, Ice, Compression , and
Elevation). At that point it took about 6 weeks for him
to heal spontaneously. He is otherwise healthy and in
good shape. His pain responds somewhat to
Celebrex.
In the past he was a heavy smoker till he quitted 10
years ago, his parents are healthy but he recalls his
grandmother to have arthritis of the knees, requiring
her to have a total knee replacement .
On exam there was minimal
edema or swelling with
tenderness to touch to the medial aspect (inner side of
the knee). His X-Ray showed Calcification or thickening
of superior part (medical lingo: upper part ) of the
Medial collateral Ligament, as if it was recalling it's
unwanted memories.
This condition is also known as Pellegrini-Stieda
disease.
X-Ray;
please note the the thickening and calcification of
medial collateral ligament, due to
a 20 year old ski accident.
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