William Craddock1, Troy Smithers2, Craig Harris3, William du Moulin4, Robert Molnar2. 1. Eastern Suburbs Sports Medicine Centre, Level 1, East Tower 9-13 Bronte Rd, Bondi Junction, Sydney, NSW 2022, Australia. 2. Sydney Orthopaedic Trauma & Reconstructive Surgery, Suite 5/Level 2, 19 Kensington Street, Kogarah, Sydney, NSW 2217, Australia. 3. Norwest Medical Imaging, 6 Meridan Pl, Bella Vista, Sydney, NSW 2153, Australia. 4. Sydney Orthopaedic Trauma & Reconstructive Surgery, Suite 5/Level 2, 19 Kensington Street, Kogarah, Sydney, NSW 2217, Australia. Electronic address: wdumoulin@orthotrauma.com.au.
Abstract
BACKGROUND: Posterior cruciate ligament (PCL) injuries of the knee are common and sometimes difficult to diagnose. Magnetic resonance imaging (MRI), performed using standard orthogonal plane views, is the investigation of choice. It can be particularly difficult to differentiate acute partial and complete tears and identify elongation of chronic healed tears. The aim of the paper is to describe a new method of positioning the patient with the knee flexed at 90°, allowing the PCL to be visualised in a position of greatest length and tension which may assist in differentiating and identifying these injuries. METHODS: Four symptomatic patients with suspected PCL injuries, two acute and two chronic, were MRI scanned using a routine protocol with the knee in extension before performing oblique sagittal fast spin-echo (FSE) proton-density (PD) sequences with the knee positioned in 90° of flexion. The appearance of the PCLs were then qualitatively assessed. RESULTS: MRI scanning with the knee in flexion identified more extensive PCL injury than standard imaging. In the two patients with acute injuries, partial tears on the standard orthogonal plane views were found to be complete ruptures. In the two patients with chronic injuries, elongation of the PCL not identifiable on the standard orthogonal plane views was apparent. CONCLUSION: MRI scanning of the PCL with the knee flexed at 90° may help in differentiating partial and complete ruptures of the PCL and identifying elongation of the PCL in chronic injuries.
BACKGROUND: Posterior cruciate ligament (PCL) injuries of the knee are common and sometimes difficult to diagnose. Magnetic resonance imaging (MRI), performed using standard orthogonal plane views, is the investigation of choice. It can be particularly difficult to differentiate acute partial and complete tears and identify elongation of chronic healed tears. The aim of the paper is to describe a new method of positioning the patient with the knee flexed at 90°, allowing the PCL to be visualised in a position of greatest length and tension which may assist in differentiating and identifying these injuries. METHODS: Four symptomatic patients with suspected PCL injuries, two acute and two chronic, were MRI scanned using a routine protocol with the knee in extension before performing oblique sagittal fast spin-echo (FSE) proton-density (PD) sequences with the knee positioned in 90° of flexion. The appearance of the PCLs were then qualitatively assessed. RESULTS: MRI scanning with the knee in flexion identified more extensive PCL injury than standard imaging. In the two patients with acute injuries, partial tears on the standard orthogonal plane views were found to be complete ruptures. In the two patients with chronic injuries, elongation of the PCL not identifiable on the standard orthogonal plane views was apparent. CONCLUSION: MRI scanning of the PCL with the knee flexed at 90° may help in differentiating partial and complete ruptures of the PCL and identifying elongation of the PCL in chronic injuries.
Authors: Lena Marie Wilms; Karl Ludger Radke; David Latz; Thomas Andreas Thiel; Miriam Frenken; Benedikt Kamp; Timm Joachim Filler; Armin Michael Nagel; Anja Müller-Lutz; Daniel Benjamin Abrar; Sven Nebelung Journal: Quant Imaging Med Surg Date: 2022-08
Authors: Shi Weili; Meng Qingyang; Chen Nayun; Ma Yong; Yang Yuping; Liu Ping; Ao Yingfang; Gong Xi Journal: BMC Musculoskelet Disord Date: 2022-03-23 Impact factor: 2.362