Case ReportA Case of Medial Tibial Crest Friction Syndrome: A Rare Cause of Medial Knee PainJohnson, Wade O. DO*; Johnson, Adam C. MD†; Payne, Jeffrey M. MD*Author Information *Departments of Physical Medicine and Rehabilitation; and †Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota. Corresponding Author: Jeffrey M. Payne, MD, Mayo Clinic Sports Medicine Center, 600 Hennepin Ave, #310, Minneapolis MN 55403 ([email protected]). The authors report no conflicts of interest. Clinical Journal of Sport Medicine: July 2021 - Volume 31 - Issue 4 - p e210-e212 doi: 10.1097/JSM.0000000000000782 Buy Metrics Abstract Knee pain is among the most common problems in active patients, with common causes of medial knee pain including meniscal injury, osteoarthritis, medial collateral ligament (MCL) injury, and pes anserine bursopathy/distal hamstring tendinopathy. Some cases of medial knee pain are refractory to standard treatment options and may be caused by rare pathology. We present a case of medial knee pain secondary to medial tibial crest friction syndrome (MTCFS) in a 22-year-old male training for a sprint triathlon after rapidly increasing his training program. Magnetic resonance imaging revealed bone marrow and soft-tissue edema about the MTC deep to the MCL consistent with MTCFS. The patient failed a period of relative rest and activity modification, but improved with corticosteroid injection deep to the MCL in the location of his symptoms. This case highlights a potential management option for MTCFS, a disorder previously described only in radiologic literature. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.