Last reviewed:October 2019
Last updated:November  2017



History and exam

Key diagnostic factors

  • injury due to excessive or repetitive valgus loading of MCL
  • medial knee pain
  • joint effusion
  • tenderness
  • laxity on valgus stress testing

Other diagnostic factors

  • ecchymosis
  • audible pop or tearing sensation at time of injury
  • difficulty walking
  • instability symptoms of knee
  • mechanical knee symptoms
  • knee deformity
  • positive anterior drawer test
  • positive posterior drawer test
  • positive Lachman test
  • positive pivot shift test
  • joint line tenderness
  • chronic pain

Risk factors

  • participation in activities involving valgus stress at the knee joint
  • age 20 to 35 years
  • age 55 to 70 years
  • weak muscles that cross the medial aspect of knee

Diagnostic investigations

1st investigations to order

  • plain x-rays of knee
  • stress x-rays of knee
Full details

Emerging tests

  • diagnostic ultrasound
Full details

Treatment algorithm


Sanjeev Bhatia

Director of Joint Preservation and Hip Arthroscopy

Cincinnati Sports Medicine & Orthopaedic Center

Cincinnati Sports Medicine Research & Educational Foundation




SB receives royalties from the following Nova publication: Ligamentous Injuries of the Knee.

Nikhil N. Verma

Associate Professor

Department of Orthopedic Surgery

Section of Sports Medicine

Rush University Medical Center




NNV is a board member of the American Orthopaedic Society for Sports Medicine, American Shoulder and Elbow Surgeons, Arthroscopy Association Learning Center Committee, Arthroscopy, Journal of Knee Surgery, and SLACK Incorporated; receives grants from Arthrex, Inc., Arthrosurface, DJ Orthopaedics, Ossur, Smith & Nephew, Athletico, ConMed Linvatec, Miomed, and Mitek; consultancy fees from Minivasive and Orthospace; stock or stock options from Cymedica, Omeros and Minivasive; publishing royalties, financial or material support from Arthroscopy and Vindico Medical-Orthopedics Hyperguide; and IP royalties and consultancy fees from Smith & Nephew.

Peer reviewersVIEW ALL

Co-director of Orthopedic Sports and Shoulder Service

Department of Orthopedic Surgery

Naval Medical Center San Diego

San Diego



DJS declares that he has no competing interests.


Chief of Physical Medicine and Rehabilitation

Ann Arbor VA Medical Center

Ann Arbor



RW has been reimbursed by the University of Michigan for attending several conferences and has been paid an honorarium for speaking at the American Association of Neuromuscular and Electrodiagnostic Medicine national meeting. RW has been paid by the National Institute for Occupational Safety and Health, the American Dental Association, and SmartHealth as a consultant and has received grant funding from the UAW/GM Health and Safety Board (over US$1 million).

Assistant Director

Orthopaedic Shoulder and Sports Surgery

Naval Medical Center San Diego

San Diego



MTP declares that he has no competing interests.

Clinical Assistant Professor of Medicine

Robert Wood Johnson Medical School

University of Medicine and Dentistry of New Jersey




PHC declares that he has no competing interests.

Orthopedic Surgeon

Department of Orthopedic Surgery

Seoul Veterans Hospital


South Korea


JRY declares that she has no competing interests.

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