Pellegrini-Stieda (PS) lesions in the knee… ever heard of this?

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We have recently come across a patient with vague inner knee symptoms and knee stiffness with a altered gait pattern. So we did some research…. we ended up diagnosing with Pellegrini- Stieda. We are having success with this patient and thought that others may benefit from this information.


Pellegrini-Stieda (PS) lesions are boney post-traumatic lesions at (or near) the medial femoral collateral ligament on this inside of the knee. Onepossible mechanism of injury is a Stieda fracture (avulsion injury of the medial collateral ligament at the medial femoral condyle). Calcification usually begins to form a few weeks after the initial injury as the bodies response to healing. Many patients, doctors (and physios) can assume that the ligamant has been torn from the clinical presentation.

Clinical presentation

Knee stiffness, some alteration in gait. Others are almost asymptomatic while a small proportion will have medial knee pain.



Mild and moderate cases are often conservatively managed with physio aiming to restore movement, normalise muscle function and improve gait. Modification of activity is important. Surgical excision of calcifications and MCL repair is considered mainly for extreme cases with significant impairment.

Differential diagnosis

Tendinous calcification often has other degenerative changes

Meniscal thickening: tender over joint line, associate knee stiffness, can present like a rigid semi locked knee


Cool Name: where did it come from?

It is named after Augusto Pellegrini (1877-1958) Italian surgeon and Alfred Stieda (1869-1945) German surgeon .

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