Internal Medicine Residency, Trinity Health Grand Rapids Hospital, Grand Rapids, Michigan, USA
Orthopaedics, Trinity Health Grand Rapids Hospital, Grand Rapids, Michigan, USA.
BMJ Case Rep. 2023 Aug 14;16(8):e253307. doi: 10.1136/bcr-2022-253307.
The anterior cruciate ligament (ACL) is the most frequently injured knee ligament, typically in non-contact athletic injuries in young adults. Mucoid degeneration of the ACL (ACL-MD) is an uncommon ACL pathology in which glycosaminoglycans deposition within the collagenous bundles leads to hypertrophy, loss of full knee flexion and knee pain without instability. ACL-MD usually presents in individuals over 40 years with sudden-onset knee pain after minimal trauma or as an incidental MRI finding. ACL-MD is rarely described in young adults. We present a case of ACL-MD in a previously healthy adult in his early 20s who presented with 3-month recalcitrant dull left knee pain and limited range of motion after 'stepping funny' with slight twisting. This case highlights the need to critically reflect on the anatomical structures when presented with musculoskeletal pathologies and to consider the unique presentation of musculoskeletal disease in atypical age groups.
前交叉韧带（ACL）是最常受伤的膝关节韧带，通常发生在年轻人的非接触性运动损伤中。ACL 的黏液样变性（ACL-MD）是一种不常见的 ACL 病理，其中糖胺聚糖在胶原束内沉积导致肥大、完全膝关节屈曲丧失和膝关节疼痛而无不稳定。ACL-MD 通常发生在 40 岁以上的人群中，表现为轻微创伤后突发膝关节疼痛或偶然 MRI 发现。ACL-MD 在年轻人中很少见。我们报告了一个 20 多岁的健康成年人的 ACL-MD 病例，该患者在“滑稽地踏足”后出现 3 个月的顽固性左膝隐痛和活动范围受限，伴有轻微扭转。该病例强调了在出现肌肉骨骼病变时需要批判性地反思解剖结构，并考虑到非典型年龄段肌肉骨骼疾病的独特表现。
