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Partial tear of proximal medial collateral ligament, with lateral femoral contusion, small joint effusion, and intact cruciate ligaments and menisci.

USU Teaching File MUTF - MedPix

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Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Partial tear of proximal medial collateral ligament, with lateral femoral contusion, small joint effusion, and intact cruciate ligaments and menisci.

History: 24-year-old active duty Navy man with left knee pain following sports-related injury. AP, lateral and oblique radiographs performed at an outside clinic one week prior to admission were reported to show suprapatellar joint effusion with no evidence of fractures. MRI was subsequently done at our institution to evaluate for ligamentous injury, particularly of the medial collateral cruciate ligaments, and meniscal tears.

Findings: FSE T2-weighted with fat-saturation axial: Increased signal intensity due to excess joint fluid and high signal intensity within medial collateral ligament fibersT1-weighted coronal: Low signal intensity on lateral femoral condyle, with poor visualization of MCLFSE T2-weighted coronal: High signal intensity along lateral femoral condyle, indicating contusion, as well as significant attenuation of the MCL, with only superficial fibers intact. The anterior cruciate ligament is intact.T1-weighted sagittal: Low signal intensity in posterolateral femoral condyle with osteochondral depression consistent with compression fracture. Lateral meniscus is intact.FSE T2-weighted with fat saturation sagittal oblique: Suprapatellar joint effusion as mentioned earlier, as well as intact posterior cruciate ligament.Interpretations: Both cruciate ligaments intact. Collateral ligaments show partial disruption of medial collateral ligament proximally, with some intact fibers, and lateral collateral ligament complex with intact iliotibial band. Fibular collateral ligament and biceps femoris tendons are intact. There is mild increased intrasubstance signal within the posterior horn of the medial and lateral menisci, but no focal tear was identified.Bone marrow edema is noted involving the posterior aspect of the lateral femoral condyle and fibular head. This most likely represents contusion from direct impact, resulting in valgus stress and disruption of medial collateral ligament. The remainder of the osseous structures and the articular cartilage are intact with no focal defects.

Ddx: Partial medial collateral ligament rupture.

Exam: No medical record available, but clinicians stated that although he was ambulatory, he had pain with valgus stress and joint swelling. No laboratory data available.

No MeSH data available.


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Partial tear of proximal medial collateral ligament, with lateral femoral contusion, small joint effusion, and intact cruciate ligaments and menisci.

USU Teaching File MUTF - MedPix

Cor T2FS post
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1080&req=5

MPX1080_synpic18328: Cor T2FS post

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Partial tear of proximal medial collateral ligament, with lateral femoral contusion, small joint effusion, and intact cruciate ligaments and menisci.

History: 24-year-old active duty Navy man with left knee pain following sports-related injury. AP, lateral and oblique radiographs performed at an outside clinic one week prior to admission were reported to show suprapatellar joint effusion with no evidence of fractures. MRI was subsequently done at our institution to evaluate for ligamentous injury, particularly of the medial collateral cruciate ligaments, and meniscal tears.

Findings: FSE T2-weighted with fat-saturation axial: Increased signal intensity due to excess joint fluid and high signal intensity within medial collateral ligament fibersT1-weighted coronal: Low signal intensity on lateral femoral condyle, with poor visualization of MCLFSE T2-weighted coronal: High signal intensity along lateral femoral condyle, indicating contusion, as well as significant attenuation of the MCL, with only superficial fibers intact. The anterior cruciate ligament is intact.T1-weighted sagittal: Low signal intensity in posterolateral femoral condyle with osteochondral depression consistent with compression fracture. Lateral meniscus is intact.FSE T2-weighted with fat saturation sagittal oblique: Suprapatellar joint effusion as mentioned earlier, as well as intact posterior cruciate ligament.Interpretations: Both cruciate ligaments intact. Collateral ligaments show partial disruption of medial collateral ligament proximally, with some intact fibers, and lateral collateral ligament complex with intact iliotibial band. Fibular collateral ligament and biceps femoris tendons are intact. There is mild increased intrasubstance signal within the posterior horn of the medial and lateral menisci, but no focal tear was identified.Bone marrow edema is noted involving the posterior aspect of the lateral femoral condyle and fibular head. This most likely represents contusion from direct impact, resulting in valgus stress and disruption of medial collateral ligament. The remainder of the osseous structures and the articular cartilage are intact with no focal defects.

Ddx: Partial medial collateral ligament rupture.

Exam: No medical record available, but clinicians stated that although he was ambulatory, he had pain with valgus stress and joint swelling. No laboratory data available.

No MeSH data available.