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1. Right ACL tear 2. Grade II right MCL tear 3. Right medial meniscus posterior horn tear

USU Teaching File MUTF - MedPix

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: 1. Right ACL tear 2. Grade II right MCL tear 3. Right medial meniscus posterior horn tear

History: Patient is a 29yo AD 2 weeks s/p twisiting injury of right knee from fall while snowboarding, DOI 27DEC01. Pt recalls going off jump, approximately 16 feet, and landing upright on ice-packed snow with a twisting and hyperextension of lower body with a snapping sensation of rt knee. Pt had immediate pain, was able to continue to bottom of hill. Pt denies any immediate swelling.

Findings: Plain X-rays were unremarkable MRI of the right knee- There is mild edema in the posterior/posterolateral aspect of the lateral femoral condyle in a subchodral location. ACL has an abnormal appearance and configuration with disruption of the distal fibers consistent with an ACL tear. PCL is abnormally thickened with intermediate signal on T1 images and surrounding edema noted on T2 images. The medial collateral ligament is abnormally thickened and contains high signal (striated appearance), representing a partial thickness tear. The lateral collateral ligament is intact. Articular surfaces are notable for mild chondral irregularity and fissuring of the medial patellar facet inferiorly. Mild chondral irregularity of the weight-bearing and posterior portion of the medial femoral condyle. No definite focal defects are seen. There is a complex tear of the posterior horn and midbody of the medial meniscus with extrusion of the meniscus both anteriorly and laterally. The posterior horn of the lateral meniscus contains some intrasubstance high signal but no definite tear.

Ddx: 1. Right ACL tear 2. PCL sprain 3. Right medial meniscus complex tear 4. Partial thickness tear of the MCL 5. Chondromalacia

Exam: SLIGHT VARUS ALIGNMENT, + JOINT EFFUSION OF RT KNEE, + RT QUAD ATROPHY TTP RT MEDIAL EPICONDYLE/TIBIA ROM: R KNEE 0/4/135, L KNEE 8/0/145 RT KNEE +LACHMAN 14mm NO END POINT, LT KNEE 5mm WITH END POIN TRT KNEE GAPS 9mm WITH VALGUS STRESS @ 30DEG, LT KNEE GAPS 3mm - VARUS INSTABILITY, -DIAL TEST SYMMETRIC @ 30/90DEG

No MeSH data available.


MRI of the right knee-  There is mild edema in the posterior/posterolateral aspect of the lateral femoral condyle in a subchodral location.  No marrow or cortical signal abnormalities are seen.  ACL has an abnormal appearance and configuration with disruption of the distal fibers.  PCL is abnormally thickened with intermediate signal on T1 images and surrounding edema noted on T2 images.  The medial collateral ligament is abnormally thickened and contains high signal (striated appearance), representing a partial thickness tear.  The lateral collateral ligament is intact.  The medial and lateral patellar retinacula and extensor mechanism are normal.   Articular surfaces are notable for mild chondral irregularity and fissuring of the medial facet inferiorly.   Mild chondral irregularity of the weight-bearing and posterior portion of the medial femoral condyle. No definite focal defects are seen.There is a complex tear of the posterior horna and midbody of the medial meniscus with extrusion of the meniscus both anteriorly and laterally.  The posterior horn of the lateral meniscus contains some intrasubstance high signal but no definite tear.
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MPX1728_synpic17065: MRI of the right knee- There is mild edema in the posterior/posterolateral aspect of the lateral femoral condyle in a subchodral location. No marrow or cortical signal abnormalities are seen. ACL has an abnormal appearance and configuration with disruption of the distal fibers. PCL is abnormally thickened with intermediate signal on T1 images and surrounding edema noted on T2 images. The medial collateral ligament is abnormally thickened and contains high signal (striated appearance), representing a partial thickness tear. The lateral collateral ligament is intact. The medial and lateral patellar retinacula and extensor mechanism are normal. Articular surfaces are notable for mild chondral irregularity and fissuring of the medial facet inferiorly. Mild chondral irregularity of the weight-bearing and posterior portion of the medial femoral condyle. No definite focal defects are seen.There is a complex tear of the posterior horna and midbody of the medial meniscus with extrusion of the meniscus both anteriorly and laterally. The posterior horn of the lateral meniscus contains some intrasubstance high signal but no definite tear.


1. Right ACL tear 2. Grade II right MCL tear 3. Right medial meniscus posterior horn tear

USU Teaching File MUTF - MedPix

MRI of the right knee-  There is mild edema in the posterior/posterolateral aspect of the lateral femoral condyle in a subchodral location.  No marrow or cortical signal abnormalities are seen.  ACL has an abnormal appearance and configuration with disruption of the distal fibers.  PCL is abnormally thickened with intermediate signal on T1 images and surrounding edema noted on T2 images.  The medial collateral ligament is abnormally thickened and contains high signal (striated appearance), representing a partial thickness tear.  The lateral collateral ligament is intact.  The medial and lateral patellar retinacula and extensor mechanism are normal.   Articular surfaces are notable for mild chondral irregularity and fissuring of the medial facet inferiorly.   Mild chondral irregularity of the weight-bearing and posterior portion of the medial femoral condyle. No definite focal defects are seen.There is a complex tear of the posterior horna and midbody of the medial meniscus with extrusion of the meniscus both anteriorly and laterally.  The posterior horn of the lateral meniscus contains some intrasubstance high signal but no definite tear.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1728&req=5

MPX1728_synpic17065: MRI of the right knee- There is mild edema in the posterior/posterolateral aspect of the lateral femoral condyle in a subchodral location. No marrow or cortical signal abnormalities are seen. ACL has an abnormal appearance and configuration with disruption of the distal fibers. PCL is abnormally thickened with intermediate signal on T1 images and surrounding edema noted on T2 images. The medial collateral ligament is abnormally thickened and contains high signal (striated appearance), representing a partial thickness tear. The lateral collateral ligament is intact. The medial and lateral patellar retinacula and extensor mechanism are normal. Articular surfaces are notable for mild chondral irregularity and fissuring of the medial facet inferiorly. Mild chondral irregularity of the weight-bearing and posterior portion of the medial femoral condyle. No definite focal defects are seen.There is a complex tear of the posterior horna and midbody of the medial meniscus with extrusion of the meniscus both anteriorly and laterally. The posterior horn of the lateral meniscus contains some intrasubstance high signal but no definite tear.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: 1. Right ACL tear 2. Grade II right MCL tear 3. Right medial meniscus posterior horn tear

History: Patient is a 29yo AD 2 weeks s/p twisiting injury of right knee from fall while snowboarding, DOI 27DEC01. Pt recalls going off jump, approximately 16 feet, and landing upright on ice-packed snow with a twisting and hyperextension of lower body with a snapping sensation of rt knee. Pt had immediate pain, was able to continue to bottom of hill. Pt denies any immediate swelling.

Findings: Plain X-rays were unremarkable MRI of the right knee- There is mild edema in the posterior/posterolateral aspect of the lateral femoral condyle in a subchodral location. ACL has an abnormal appearance and configuration with disruption of the distal fibers consistent with an ACL tear. PCL is abnormally thickened with intermediate signal on T1 images and surrounding edema noted on T2 images. The medial collateral ligament is abnormally thickened and contains high signal (striated appearance), representing a partial thickness tear. The lateral collateral ligament is intact. Articular surfaces are notable for mild chondral irregularity and fissuring of the medial patellar facet inferiorly. Mild chondral irregularity of the weight-bearing and posterior portion of the medial femoral condyle. No definite focal defects are seen. There is a complex tear of the posterior horn and midbody of the medial meniscus with extrusion of the meniscus both anteriorly and laterally. The posterior horn of the lateral meniscus contains some intrasubstance high signal but no definite tear.

Ddx: 1. Right ACL tear 2. PCL sprain 3. Right medial meniscus complex tear 4. Partial thickness tear of the MCL 5. Chondromalacia

Exam: SLIGHT VARUS ALIGNMENT, + JOINT EFFUSION OF RT KNEE, + RT QUAD ATROPHY TTP RT MEDIAL EPICONDYLE/TIBIA ROM: R KNEE 0/4/135, L KNEE 8/0/145 RT KNEE +LACHMAN 14mm NO END POINT, LT KNEE 5mm WITH END POIN TRT KNEE GAPS 9mm WITH VALGUS STRESS @ 30DEG, LT KNEE GAPS 3mm - VARUS INSTABILITY, -DIAL TEST SYMMETRIC @ 30/90DEG

No MeSH data available.