Medial collateral ligament knee injury
Classic history and presentation: Patients will often present acutely with pain and swelling of the medial aspect of the knee, often with point tenderness at the femoral insertion (medial epicondyle) of the MCL. Some patients report a popping or tearing sensation at the time of injury. Mild MCL injuries may not result in significant valgus laxity, but patients with more severe lesions often report instability with lateral and pivoting maneuvers. Significant instability may indicate the involvement of additional surrounding structures or other knee ligaments being compromised (multiligamentous knee injury).
Prevalence: Contact and collision sports (wrestling, hockey, soccer, football, skiing, etc) are frequently implicated; therefore, MCL injuries frequently occur in younger, active populations.
- Age – Teenage years to fifth decade
- Sex/gender – MCL injuries predominantly affect men more than women
- Grade 1 – Less than 5 mm
- Grade 2 – 5-9 mm
- Grade 3 – 10 mm or more
M23.639 – Other spontaneous disruption of medial collateral ligament of unspecified knee
444448004 – Injury of medial collateral ligament of knee
- Posterolateral corner (PLC) injury
- Anterior cruciate ligament (ACL) injury
- Meniscal injury
- Tendinous injury – The semimembranosus, semitendinosus, gracilis, sartorial, medial gastrocnemius, quadriceps, and patellar tendons all insert medially on the tibia. Tendonitis of any of these structures could present with medial knee pain.
- Bursitis – Pes anserine or semimembranosus bursae, prepatellar or postpatellar bursitis.
- Epiphyseal injury – Distal femoral or proximal tibial epiphysis.
- Knee arthritis
- Fractures – Tibial plateau and distal femur fractures.