M76.42 Tibial collateral bursitis [Pellegrini-Stieda], left leg

Name of the Condition

Tibial collateral bursitis [Pellegrini-Stieda], left leg

Summary

Tibial collateral bursitis, also known as Pellegrini-Stieda disease, is an inflammatory condition affecting the bursa near the medial collateral ligament (MCL) of the knee. This condition typically causes localized pain and swelling in the medial knee region, often resulting from trauma or overuse. It may be associated with MCL injury or chronic stress to the area.

Causes

Tibial collateral bursitis commonly arises from direct trauma to the medial knee, such as a blow or fall, or from repetitive stress on the MCL. It can also develop secondary to MCL sprains, where inflammation extends to the adjacent bursa. Overuse activities involving knee flexion or valgus stress may contribute to irritation of the bursal tissue.

Risk Factors

• Participation in sports or activities with high knee stress, such as soccer, basketball, or skiing.
• History of knee injuries, particularly MCL sprains or medial meniscal tears.
• Age-related degeneration of the knee joint, reducing tissue resilience.
• Poor biomechanics or muscle imbalances affecting knee alignment.

Symptoms

• Localized pain and tenderness over the medial knee, often worsening with activity.
• Swelling or palpable mass in the medial knee region.
• Stiffness or reduced range of motion, particularly with knee flexion.
• Pain that worsens with weight-bearing or knee flexion.

Diagnosis

Diagnosis is based on a physical examination to assess tenderness, swelling, and movement. Imaging, such as ultrasound or MRI, may be used to evaluate tissue damage or inflammation at the bursa. Clinical correlation with patient history and symptoms is essential for confirmation.

Treatment Options

Treatment typically includes rest, ice, and anti-inflammatory medications to reduce pain and swelling. Physical therapy may be recommended to improve range of motion and strengthen surrounding muscles. In some cases, corticosteroid injections or surgical intervention may be considered for persistent symptoms.

Prognosis and Follow-Up

Most cases of tibial collateral bursitis resolve with conservative treatment within a few weeks to months. Follow-up care may involve monitoring symptoms and adjusting activity levels to prevent recurrence. Severe or chronic cases may require longer rehabilitation or additional interventions.

Complications

Untreated or recurrent bursitis may lead to chronic pain, limited mobility, or persistent swelling. In rare cases, infection of the bursa or progression to MCL instability could occur.

Lifestyle & Prevention

• Avoid activities that stress the medial knee, such as sudden twists or heavy impacts.
• Use proper footwear and maintain good knee alignment during exercise.
• Incorporate stretching and strengthening exercises for the knee and hip muscles.
• Apply ice and rest the knee after strenuous activity to reduce inflammation.

When to Seek Professional Help

Seek medical attention if pain is severe, persistent, or worsening; if swelling is significant or accompanied by redness or warmth; or if knee function is severely limited. Prompt evaluation is recommended for suspected infection or trauma.

Tips for Medical Coders

Document the laterality (left leg) and specify the condition as tibial collateral bursitis [Pellegrini-Stieda] to ensure accurate coding. Include details about trauma, overuse, or associated MCL injury if present, as these may support clinical correlation. Verify that the diagnosis aligns with the patient's symptoms and examination findings.