Chronic Medial Collateral Ligament Sprain and Medial Collateral Ligament Bursitis of the Knee in a Female Soccer Player: A Case Report

Medial collateral ligament (MCL) injury is diagnosed with clinical history and physical examination. Chronic valgus instability develops more likely after severe (grade III) MCL injuries, but may also develop after repetitive low-grade injuries. Soccer players have a susceptibility to chronic symptoms in minor injuries due to repetitive kicking with the inside of the foot and lateral movements. MCL bursitis is a rare entity but should be considered in the differential diagnosis of medial knee pain. It can be diagnosed with findings of tenderness over the MCL at the joint line, without a history of mechanical symptoms. An 18 years-old female soccer player presented with medial knee pain. She described a valgus strain injury on the right knee that occurred the day before. Physical examination showed tenderness along the MCL course. Valgus stress test was quite painful and there was (1+) valgus laxity. There wasn’t any previous severe knee trauma. The patient diagnosed with acute MCL sprain. PRICE protocol and NSAID were started. Over the course of treatment, the patient's symptoms improved faster than expected. Reevaluation of the patient suggested that the patient's valgus laxity wasn’t due to the acute trauma but chronic microtraumas. She returned to the sport at day 10. In this case report, an elusive case of posttraumatic MCL bursitis in an 18-years-old female soccer player with valgus laxity due to chronic MCL sprain is described. It should be kept in mind that chronic MCL injury may cause increased laxity in soccer players. In the case of acute valgus injury, presence of laxity may be a confusing factor in physical examination.

Kadın Futbolcuda Dizin Kronik İç Yan Bağ Yaralanması ve İç Yan Bağ Bursiti: Olgu Sunumu

İç yan bağ (İYB) yaralanmalarında tanı klinik öykü ve fizik muayene ile konur. Kronik valgus instabilitesi şiddetli İYB yaralanmalarından (3.derece) sonra ortaya çıkabileceği gibi tekrarlayan düşük dereceli yaralanmalar ile de gelişebilir. Futbolcularda tekrarlayan ayak içi şutlar ve yana hareketler ile kronik semptomlara yol açan düşük dereceli yaralanmalar görülebilir. İYB bursiti nadir görülen bir hastalıktır, ancak iç diz ağrısının ayırıcı tanısında düşünülmelidir. Mekanik semptomlar olmaksızın İYB üzerinde eklem çizgisi hizasında hassasiyet olması İYB bursitinin varlığını düşündürür. 18 yaşında bir kadın futbolcu iç diz ağrısı ile kliniğimize başvurdu. Önceki gün sağ dizi valgusa zorlanmıştı. Fizik muayenesinde İYB seyri boyunca hassasiyet saptandı. Valgus stres testi oldukça ağrılıydı ve valgus laksitesi (1+) vardı. Daha önce geçirilmiş ciddi diz yaralanma öyküsü yoktu. Hastaya akut İYB zedelenmesi tanısı kondu. “PRICE” protokolü ve NSAİİ başlandı. Tedavi sırasında semptomları beklenenden daha hızlı düzelen hasta yeniden değerlendirildi. Hastanın laksitesinin akut travma nedeniyle değil kronik tekrarlayan mikro travmalar nedeniyle olduğu anlaşıldı. Hasta 10 günde spora geri döndü. Kronik İYB zedelenmesi nedeniyle valgus laksitesi olan 18 yaşındaki kadın futbolcuda, travma sonrası İYB bursiti gelişmiştir. Kronik İYB hasarının futbolcularda artmış laksiteye neden olabileceğini akılda tutulmalıdır. Akut valgus hasarı durumunda, laksite varlığı fizik muayenede kafa karıştırıcı bir faktör olabilir.

Kaynakça

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Kaynak Göster

Spor Hekimliği Dergisi
  • ISSN: 1300-0551
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1966

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