Proximal MCL osseous avulsion

Case contributed by Matt Skalski
Diagnosis certain

Presentation

Knee trauma.

Patient Data

Age: 46
Gender: Female
x-ray

There is a large osseous fragment along the medial femoral epicondyle at the expected attachment for the proximal medial collateral ligament, with multiple adjacent small comminuted fragments.  This fragment is displaced from its parent site by approximately 5mm. 

A mild suprapatellar effusion is noted. 

Case Discussion

Typically, when the proximal medial femoral collateral ligament (MCL) is injured, it is seen as a sprain, partial or complete tear on MRI. When this occurs, it may later calcify to produce a pellegrini stieda lesion. In this case, however, the MCL managed to hold on and drag a piece of the femur down with it when it was avulsed, which is known as a Stieda fracture

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