POSTGRADUATE ORTHOPEDIC INSTRUCTION - IMAGING

Case Presentation

Juan Pablo Ghisi,^* Joaquín Escotorín^**

^*Magnetic Resonance Imaging Department, Hospital General de Agudos “Dr. Juan A. Fernández”, Autonomous City of Buenos Aires, Argentina

^**Diagnostic Imaging Department, Sanatorio San Lucas, San Isidro, Buenos Aires, Argentina

Case Resolution on page 184.

Knee Pain

ABSTRACT

Two cases with similar clinical presentations are reported. In both cases, imaging evaluation showed comparable findings involving the capsuloligamentous structures of the medial aspect of the knee.

Keywords: Knee; calcifications; pain

Level of Evidence: IV

Gonalgia

RESUMEN

Se presentan dos casos con un cuadro clínico similar. En ambos, los estudios por imágenes mostraron hallazgos comparables, localizados en relación con las estructuras capsuloligamentarias de la cara medial de la rodilla.

Palabras clave: Rodilla; calcificaciones; dolor.

Nivel de Evidencia: IV

INTRODUCTION

Two cases with similar clinical presentations are reported. In both cases, imaging evaluation showed comparable findings involving the capsuloligamentous structures of the medial aspect of the knee.

CASE 1

A 40-year-old man presented with predominantly medial knee pain, with pain-related functional limitation and no relevant history of trauma. Imaging studies, including plain radiographs and magnetic resonance imaging (MRI), were requested due to suspected involvement of the medial capsuloligamentous compartment. Laboratory tests showed no clinically significant abnormalities; acute-phase reactants were not elevated, and there were no signs of systemic involvement.

CASE 2

A 50-year-old man presented with medial knee pain. As an initial evaluation, a soft-tissue ultrasound focused on the medial aspect of the knee was requested. Based on the findings, the evaluation was completed with MRI for better anatomical characterization of the lesion and its relationship to adjacent capsuloligamentous structures.

IMAGING FINDINGS AND INTERPRETATION

CASE 1

The knee radiograph (Figure 1) showed faint calcifications projected over the medial aspect. On MRI (Figures 2 and 3), multiple foci of signal void with a multilobulated morphology and irregular margins were observed around the capsule and anterior to the femoral insertion of the medial collateral ligament, associated with edema of the adjacent soft tissues. The medial collateral ligament was thickened, with altered signal intensity in its proximal segment, consistent with reactive changes.

CASE 2

Ultrasound of the medial aspect of the knee (Figure 4) showed two focal echogenic foci with mild posterior acoustic shadowing, located immediately anterior to the femoral insertion of the medial collateral ligament. MRI (Figures 5 and 6) confirmed, in the same medial pericapsular location, two foci of signal void associated with perilesional inflammatory edema, without evidence of ligament discontinuity.

In both cases, imaging studies demonstrated calcium deposits at the insertion of the medial capsuloligamentous complex, associated with inflammatory changes in the adjacent soft tissues.

J. Escotorín ORCID ID: https://orcid.org/0009-0006-4115-1034

Received on March 13th, 2026. Accepted after evaluation on March 19th, 2026 • Dr. JUAN PABLO GHISI • jpghisi@gmail.com • https://orcid.org/0000-0001-7991-9228

How to cite this article: Ghisi JP, Escotorín J. Postgraduate Orthopedic Instruction – Imaging. Case Presentation. Rev Asoc Argent Ortop Traumatol 2026;91(2):79-82. https://doi.org/10.15417/issn.1852-7434.2026.91.2.2324

Article Info

Identification: https://doi.org/10.15417/issn.1852-7434.2026.91.2.2324

Published: April, 2026

Conflict of interests: The authors declare no conflicts of interest.

License: This article is under Attribution-NonCommertial-ShareAlike 4.0 International Creative Commons License (CC-BY-NC-SA 4.0).