Review Question - QID 20

The double PCL sign may be seen on a sagittal MRI image when a torn meniscal fragment is flipped and displaced into the notch. In a retrospective analysis of 71 knee MRI examinations as compared to a gold standard of arthroscopy, Dorsay et al noted that the double PCL sign demonstrated a specificity of 100% for flipped bucket handle meniscal tears. The absent bow tie sign had a sensitivity of 88.4% and the presence of at least one displaced fragment sign had a sensitivity of 90.7%. The second reference by Ververidis et al demonstrated that the most common signs seen on MRI with a bucket handle meniscal tear are the fragment in the notch sign, the absent bow tie sign, and the double PCL sign. Illustration A shows a sagittal MRI of a bucket-handle meniscal tear and a double PCL sign.