Medial collateral ligament bursitis

Last revised by Joachim Feger on 7 Feb 2024

Medial collateral ligament bursitis or tibial collateral ligament bursitis is the acute or chronic inflammation of the medial collateral ligament bursa which is located between the superficial and deep layers of the medial collateral ligament 1-5.

In isolation, medial collateral ligament bursitis is extremely rare 2.

  • knee arthritis 2

  • overuse (e.g. riding or motorcycling)

Nowadays the diagnosis might be established by the combination of typical clinical symptoms and evidence of typical imaging appearance of a distended medial collateral ligament bursa as well as the documented absence of a medial collateral ligament injury and a medial meniscal tear 4.

Clinically medial collateral ligament bursitis may present as swelling, pain and tenderness at the medial aspect of the knee in the area of the joint line 5. The pain might get more severe with knee extension.

Pathologically this is an inflammatory process affecting the synovial lining of a bursa, which then becomes distended 1-4. This might happen due to mechanical friction or in association with autoimmune disease or rheumatological disorders 3,4.

Typical radiographic features on imaging include the following 4:

  • distended bursa

  • absence of medial collateral injury

  • absence of related meniscal tear

On ultrasound medial collateral bursitis can be seen as a well-defined fluid collection between the superficial and deep portions of the medial collateral ligament 4,6.

Medial collateral ligament bursitis will usually appear as a well-defined fluid-filled sac or bursa between the superficial and deep fibers of the medial collateral ligament 1.

  • T1: hypointense

  • T2: hyperintense

The description should contain the following:

  • presence of fluid between the superficial and deep fibers of the medial collateral ligament

  • presence of inflammatory change

  • absence of meniscal tear and or displacement

Treatment is usually conservative 4,5 and might include a short course of nonsteroidal anti-inflammatory drugs or other pain medications as well as local application of ice, strengthening and stretching exercises to alleviate the pain. Activity modifications should be considered if overuse or a specific activity has caused the bursitis. Additional options include ultrasound-guided cortisone and lidocaine injections to reduce inflammation and pain 5. Recalcitrant cases might require arthroscopy 5 and calcificic bursitis can be additionally treated by shockwave therapy or ultrasound-guided percutaneous lavage 6.

The medial collateral ligament bursa was first described by the American surgeon and surgical anatomist Otto C Brantigan and the orthopedic surgeon Allen F Voshell in 1943 7. The disorder was later further characterized by the radiologist Robert K Kerlan and orthopedic surgeon Ronald E Glousman in 1988 4.

On imaging studies, medial collateral ligament bursitis might be  mimicked by the following 1,2,8:

ADVERTISEMENT: Supporters see fewer/no ads

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.