MyPACS.net: Radiology Teaching Files > Case 462231

never visited ACL TEAR WITH POSTEROLATERAL CORNER INJURY
Contributed by: Herman Wu, Radiologist, University of California, San Diego, California, USA.
Patient: 46 year old male
History: 46 year old male with knee twisting injury on 4/16/04.
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Fig. 1: Sagittal PD FSE with fat sat: there is a complete tear of the ACL. There is also disruption of the posterior joint capsule.

Fig. 2: Sagittal PD FSE with fat sat: there is a full-thickness cartilage defect of the medial femoral condyle.

Fig. 3: Sagittal PD: there is a complex tear of the posterior horn of the medial meniscus.

Fig. 4: Sagittal PD: there is a radial tear of the posterior horn of the lateral meniscus.

Fig. 5: Sagittal PD FSE with fat sat: there is bone marrow contusion of the posterolateral tibial plateau. There is also fluid posterior to the popliteus, indicative of posterolateral corner injury.

Fig. 6: Sagittal PD FSE with fat sat: there is also linear fluid signal involving the fibular head, indicative of avulsion fracture.

Fig. 7

Fig. 8: Sagittal PD FSE with fat saturation: there is also associated deep notch sign of the lateral femoral condyle.

Fig. 9: Coronal PD FSE with fat sat: there is abnormal signal in the fibular collateral ligament, as well as around the medial collateral ligament, consistent with ligament injury.

Fig. 10: Coronal PD FSE with fat sat: there is abnormal popliteus tendon signal as well.

Fig. 11: Coronal PD FSE with fat sat: there is a partial thickness tear of the MCL superiorly.

Fig. 12: Coronal PD FSE with fat sat: again showing the MCL injury. There is also disruption of the meniscofemoral ligament (deep layer of MCL).

Fig. 13: Axial PD FSE with fat sat: there is focal disruption of the anterior fibers of the MCL. Deep notch sign is also again seen in the lateral femoral condyle.

Fig. 14: This figure from Lee et al shows the insertions of the popliteofibular ligament, the arcuate ligament, the fibular collateral ligament, and the biceps femoris tendon onto the fibular head. Given the extent of the fibular head avulsion fracture, it would appear that all these structures were involved in this case.
References: Lee et al., Skeletal Radiology 2003; 32: 619-627.
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Additional Details:

Case Number: 462231Last Updated: 04-22-2004
Anatomy: Skeletal System   Pathology: Trauma
Modality: MRExam Date: 04-22-2004Access Level: Readable by all users

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