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股二头肌钙化性肌腱炎作为膝外侧疼痛的罕见原因:一例报告

Biceps femoris calcific tendinitis as a rare cause of lateral knee pain: a case report.

作者信息

Karki Shivaji, Pokhrel Sushil, Khadka Karuna

机构信息

Department of Orthopedics, Health Service Office, Rukum West, Rukum West, Nepal.

Department of Internal Medicine, Pokhara Academy of Health Science, Pokhara, Kaski, Nepal.

出版信息

Ann Med Surg (Lond). 2025 Mar 27;87(4):2385-2387. doi: 10.1097/MS9.0000000000003021. eCollection 2025 Apr.

Abstract

INTRODUCTION

Calcific tendinitis is a common cause of periarticular pain, though it rarely affects the distal biceps femoris tendon, leading to lateral knee pain. This case report highlights a rare instance of biceps femoris calcific tendinitis and its successful conservative management.

CASE PRESENTATION

A 40-year-old female presented with a 1-week history of sharp lateral knee pain, which worsened with movement but persisted at rest. There was no history of trauma or systemic illness. On examination, tenderness was localized to the lateral knee, specifically over the fibular head and biceps femoris tendon. Blood tests were unremarkable. Radiographs and ultrasound revealed multifocal calcifications at the fibular head. Although MRI was recommended, it was not feasible in this resource-limited setting. The patient was initially treated conservatively with NSAIDs and physiotherapy but did not respond. She subsequently underwent ultrasound-guided barbotage and corticosteroid injection, resulting in the complete resolution of symptoms within 1 week.

DISCUSSION

Calcific tendinitis is caused by the deposition of calcium hydroxyapatite crystals in periarticular tendons, leading to inflammation and pain. Biceps femoris calcific tendinitis is rare, and diagnosis can be made using cost-effective imaging modalities such as radiography and ultrasound. Conservative management, including NSAIDs, physiotherapy, and ultrasound-guided barbotage, is the preferred first-line treatment. In this case, the combination of barbotage and physiotherapy led to complete symptom relief.

CONCLUSION

Biceps femoris calcific tendinitis, though rare, should be considered in cases of lateral knee pain. Early diagnosis and conservative treatment can result in rapid symptom relief.

摘要

引言

钙化性肌腱炎是关节周围疼痛的常见原因,尽管它很少影响股二头肌远端肌腱,导致膝关节外侧疼痛。本病例报告强调了一例罕见的股二头肌钙化性肌腱炎及其成功的保守治疗。

病例介绍

一名40岁女性,有1周膝关节外侧剧痛病史,活动时疼痛加重,休息时疼痛持续。无外伤或全身性疾病史。检查时,压痛局限于膝关节外侧,特别是在腓骨头和股二头肌肌腱处。血液检查无异常。X线片和超声显示腓骨头有多灶性钙化。尽管建议进行磁共振成像(MRI)检查,但在这种资源有限的情况下并不可行。患者最初接受非甾体抗炎药(NSAIDs)和物理治疗的保守治疗,但无反应。随后她接受了超声引导下的冲洗和皮质类固醇注射,症状在1周内完全缓解。

讨论

钙化性肌腱炎是由羟基磷灰石晶体在关节周围肌腱中的沉积引起的,导致炎症和疼痛。股二头肌钙化性肌腱炎很少见,可使用如X线片和超声等经济有效的成像方式进行诊断。保守治疗,包括使用NSAIDs、物理治疗和超声引导下的冲洗,是首选的一线治疗方法。在本病例中,冲洗和物理治疗相结合使症状完全缓解。

结论

股二头肌钙化性肌腱炎虽然罕见,但在膝关节外侧疼痛的病例中应予以考虑。早期诊断和保守治疗可迅速缓解症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40f8/11981373/0505795992bf/ms9-87-2385-g001.jpg

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