Chronic Knee Pain with Serpentine Calcifications: Diagnostic and Rehabilitative Challenges

Abstract

This case highlights a 66-year-old male with chronic severe knee pain persisting for 3 years, aggravated by movement and partially relieved by medications. Imaging revealed calcifications in the knee, serpentine soft-tissue calcifications in the knee, while blood investigations and Doppler studies were normal. The patient had a history of a similar condition in the contralateral knee, for which surgery provided partial relief but resulted in a fixed flexion deformity and restricted range of motion. Initial pharmacological management with nonsteroidal anti-inflammatory drugs, tramadol, duloxetine, gabapentin, and buprenorphine patches provided partial pain relief, necessitating advanced intervention such as a nerve block. Although the exact cause of pain remained multifactorial, the serpentine calcification was considered a possible contributing factor, especially in the context of coexisting osteoarthritic changes. This report underscores the importance of multimodal management in complex chronic pain cases.