(PSS), sometimes termed Pellegrini Stieda disease or Köhler–Pellegrini–Stieda disease , is an uncommon clinical entity characterized by the presence of a pelliigrini-stieda sign on knee radiographs coupled with medial...
(PSS), sometimes termed Pellegrini Stieda disease or Köhler–Pellegrini–Stieda disease , is an uncommon clinical entity characterized by the presence of a pelliigrini-stieda sign on knee radiographs coupled with medial knee pain and restricted range of motion. Pelligrini was the first to describe the sign in 1905, Stieda would later publish a series of 5 cases. The epidemiology of this disease is limited to cases and case reports and not well characterized in the literature. It is most commonly seen in young males age 25 to 40. 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. Calcific linear focus is present medial to the distal femur in the region of proximal attachment of the medial collateral ligament. The diagnostic criteria of PSS include (a) the classic findings of pelligrini stieda sign and a combination of symptomatology of pain and restricted range of motion.
The Pelligrini-Stieda sign or lesion is a radiographic finding which describes calcification of the medial collateral ligament seen weeks to months after an inciting invite. For clarities sake, a Stieda fracture is a medial femoral condyle avulsion fracture caused by an injury to the MCL . Thought to initially occur with an insult to the MCL, especially with valgus disruption of the MCL fibers which can be an (a) acute, direct trauma, (b) repetitive microtrauma and/or (c) overstretching.
Subsequently, an acute inflammatory cascade initiates a delayed process of ossification which is typically thought to occur between two and six weeks following the event.[ref]Theivendran K, Lever CJ, Hart WJ. Good result after surgical treatment of Pellegrini-Stieda syndrome. Knee Surg Sports Traumatol Arthrosc.
If you are experiencing symptoms that may be related to pellegrini stieda syndrome, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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