The means of PCL buckling ratio were also different statistically b. etween injury group(0.23 ± 0.02) and normal group(0.17 ± 0.01)(p<0.001). Buckled PCL. Interposition of the Posterior Cruciate Ligament into the Medial Compartment of the Knee Joint on Coronal Magnetic Resonance Imaging Hyun Su Kim, MD, 1 Young Cheol Yoon, MD, 1, 2 Ki Jeong Park, MD, 1 Joon Ho Wang, MD, 3 and Bong-Keun Choe, MD 4 1 Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea. Conclusions: The preoperative buckling of PCL in the case of chronic ACL injury disappeared after ACL reconstruction. Lateral Meniscus Root Tear and Meniscus Extrusion with Anterior Cruciate Ligament Tear. Our hypothesis was that PCL buckling would disappear after ACL reconstruction if it was associated with anterior tibial translation that results from ACL injury. Laxity or stretching of the PCL graft ( Fig. Conclusion 64-section MDCT has very high sensitivity and specificity for ACL tears and, as on MRI, secondary signs, such as buckling of the PCL, are also useful in their diagnosis. Buckling of the posterior cruciate ligament (PCL) was also evaluated. 2009 Dec. 253(3):780-7. Some studies associated sigmoid or curved appearance of the PCL more with chronic than acute ACL tears4). by Jeffrey M. Brody et al ... Other less-specific secondary signs include acute hemarthrosis and buckling of posterior cruciate ligament ... Radiology, 167 (1988), pp. Among the studied 620 MR images of the knee, an ACL rupture was detected in 355 cases (57.3%; 206 partial, 149 complete), complete medial meniscal tear (floating meniscus) in 110 cases (17.7%), joint effusion in 462 cases (74.5%), forward sagittal dislocation of the tibia in 214 cases (34.5%) and buckling tear of the PCL in 242 cases (39%). Key words: Knee, Magnetic resonance imaging, Anterior cruciate ligament, Posterior cruciate ligament, Buckling. A: Posterior cruciate ligament (PCL) buckling sign. 1), the entire lateral collateral ligament (LCL) seen on one coronal image, translational bone contusion in the lateral compartment (Fig. Anterior tibial translocation, when measured at the midsagittal plane of the lateral femoral condyle with regard to a plane parallel to the cephalocaudal axis of the image, was a relatively specific indicator of ACL disruption. Knee instability has been identified as a risk factor for meniscal and chondral damage, resulting in early osteoarthritis; therefore, early recognition and treatment is … Complex tear lateral meniscus composed of radial tear of the body and bucket handle tear of the posterior horn. The PCL is buckled. Meniscal tears seen commonly are grade III in medial meniscus and Grade I in lateral meniscus. The most useful secondary signs are the PCL buckle (Fig. Dr. Nissman is a Resident and Dr. Hobbs was a Musculoskeletal Fellow in the Department of Radiology and Radiological Science, Medical University of South Carolina. Both the femoral and tibial insertions of the PCL are often visualised on a single sagittal image. For posterior cruciate ligament (PCL) tears, the specificity and negative predictive value were 99% and 100%, respectively. Sagittal PD (TE<30) and fat sat PD (TE36) FOV14, slice 3mm. 769-774. Department of Radiology, Kangnam General Hospital Public Corporation. Dedicated knee coil. The incidence of posterior cruciate ligament (PCL) tears is considerably less common, accounting for 3% of all knee injuries in the general population. ... Posterior cruciate ligament. The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) are important stabilizers of the knee. Mild knee effusion. Figure 13 Posterior cruciate ligament buckling and Posterior cruciate ligament line sign. The PCL is considered to be hyperbuckled if any portion of its posterosuperior border is concave (white arrow); B: The PCL line sign. [10], by measuring an angle created by lines placed parallel to the femoral portion of the PCL and tibial portion of the PCL. Medial and lateral collateral ligaments sprains and torn arcuate ligament complex. Routine protocol and then assess. Anterior tibial translation was measured by placing vertical lines Buckling of the patellar tendon was a frequent asymptomatic variant (71%) but was also associated with joint effusions (p<0.01) and ACL tears (p=0.01). Identification of a Segond fracture ... Department of Radiology, Alberta Health Services South Zone, … Magnetic resonance imaging (MRI) is emerging as an important tool of diagnosis and evaluation of these injuries. Buckling of the posterior cruciate ligament (PCL) was also evaluated. 16) should be considered if there is knee instability with integrity of the graft fibers on MRI. The Double Posterior Cruciate Ligament Sign. Variation of the magnetic resonance appearance of … A buckled PCL is defined as when any segment of the PCL is concave posteriorly , , , . Secondary signs like Posterior cruciate ligament (PCL) buckling, PCL index of >0.5 and uncovered lateral meniscus (LM) were also noted in certain areas. Sonnin etal [14] found the incidence of PCL tear to be 3 percent. Such an appearance implies a more vertical course of the ligament related to buckling and foreshortening secondary to a PCL or ACL tear (see the images below). Bone contusions are nonspecific and can be seen in both stable and unstable tears . There is an oblique-type delicate tear demonstrated in the posterior body-horn junction of the medial meniscus measuring approximately 1cm and involving the outer one-third. Sagittal intermediate-weighted magnetic resonance knee image of a completely torn anterior cruciate ligament. Grade 2C Signal in the Mensicus on MR Imaging of the Knee. by Thomas R. McCauley et al AJR 2002; 179:645-648. ... Radiology. PCL tears were diagnosed on MRI by the disruption of it’ s fibres or an enlarged and swollen PCL For menisci, homogeneous low signal intensity was indicative of an intact meniscus where as an increased signal … Anterior tibial translation is associated. by Marc A. Camacho November 2004 Radiology, 233, 503-504. 1.11 Buckled course of the posterior cruciate ligament (PCL) as an indirect sign of complete anterior cruciate ligament (ACL) … The PCL is considered to be hyperbuckled if any portion of its posterosuperior border is concave (white arrow); B: The PCL line sign. Graft laxity is believed to be more likely with hamstring grafts. Buckling, intratendon signal, and tendon thickness increased with weight and age. 64-section MDCT has very high sensitivity and specificity for ACL tears and, as on MRI, secondary signs, such as buckling of the PCL, are also useful in their diagnosis. A: Posterior cruciate ligament (PCL) buckling sign. RESULTS. The degree of PCL buckling had no correlation with the degree of preoperative anterior instability. These ligaments are commonly injured in sports and motor vehicle accidents. However, buckling or increased curvature of the PCL may also be seen with hyperextension of the knee in the setting of a normal ACL. they termed ‘‘PCL buckling,’’ while Boeree and Ackroyd4 described a ‘‘sigmoid’’ or curled-up PCL on sagittal MRI that reliably indicates an ACL rupture. The sensitivity of MDCT for PCL tears was 0–25% with a specificity of 100%. Preferred examination MRI is the preferred examination for evaluating posterior cruciate ligament (PCL) injuries. ACL, PCL, menisci, cartilage Coronal T1 and fast STIR (or fat sat PD) Coronal T1 and Fast STIR (or fat sat PD) … 1), an “uncovering” posterior horn of the lateral meniscus (Fig. More recently, Although the PCL was intact, the musculoskeletal radiologist noted a “stable buckling” of the PCL fibers. Technique. ciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament (MCL), and the posterolateral corner complex (PLC). The posterior cruciate ligament (PCL) is a ligament within the knee.Ligaments are tough bands of tissue that connect bones. An 8 × 7 × 6-mm cystic lesion abutting the posteromedial margin of the distal 1/3 of the PCL … KNEE MRI MENISCI (PD w/ FATSAT): 2 bowtie for body of meniscus on sag view (4-5mm slices) -MEDIAL MENISCUS (post horn > ant horn) -LATERAL MENISCUS (discoid ≥3 bowties on sag and extends into IC notch on coronal)—ant horn merge with ACL and may be striated in this region; posterior horn medially may have magic-angle artifact Sagittal T2-weighted FSE fat-suppressed image shows the angle between the posterior cruciate ligament and the plane of the tibial plateau less than 107° Fig. : 2 Department of Medical … PCL buckling was defined, as reported by Mc-Cauley et al. Bowing or buckling of the plasty may be observed. Background: Due to increase in road traffic and sports injuries, tears of anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) of the knee are common. Anterior tibial translocation, when measured at the midsagittal plane of the lateral femoral condyle with regard to a plane parallel to the cephalocaudal axis of the image, was a relatively specific indicator of ACL disruption. Anterior Cruciate Ligament Tear: Comparison of MR Features between Complete and Partial Tear Ki Young Song, Joo Hyuk Lee, Jin Hee Park, Yu Jin Lee, Eun Jin Rho, Young Hoon Kim, Jeong Geun Yi and Joong Mo Ahn Department of Radiology, Kangnam General Hospital Public Corporation. Posterior cruciate ligament injuries were found to be relatively uncommon, in our study found in only 7 patients (10.15%) and among that 6 tears were demonstrated as thickening of the ligament with abnormal signal intensity (partial tear) 1 was complete tear. Swollen meniscus is demonstrated in the posterior body and posterior body-horn junction. In the level of 5mm of anterior translocation for the criteria of ACL injury, the sensitivity, specificity, accuracy were 78.7%, 89.5%, 84.3% for each. Hyperintensity, discontinuity and nonvisualisation were primary signs of ACL tear. An angle of less than 105° was considered abnormal. PCL buckling can be observed in cases of acute or chronic ACL tears. ACL rupture is seen. MDCT has a low sensitivity for other soft-tissue injuries at the knee; however, its high specificity indicates that apparent PCL, … translocation, Segond fracture and buckling of PCL. Buckling of an otherwise intact posterior cruciate ligament. The most specific secondary signs for unstable tear are anterior tibial translation, uncovering of the lateral meniscus posterior horn, and abnormal PCL buckling with specificities of 100%, but these signs had low sensitivity of 23%. Knowledge of an ACL/posterior cruciate ligament ... exposure of the posterior horn of the lateral meniscus, and buckling of the PCL and patellar tendon . Don’t angle for ACL. The sensitivity for meniscal tears was 9.1–23.1% with a specificity of 96.3–100%.

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