Review Question - QID 748

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ACL Tear Imaging MRI QID: 748 (OBQ07.87)

QID 748 (Type "748" in App Search)

A patient sustains a knee injury. The MRI image shown in Figure A is indicative of which of the following injuries?

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ACL tear

91%

2271/2493

PCL tear

124/2493

Medial meniscus tear

21/2493

Lateral meniscus tear

39/2493

Patellar tendon tear

29/2493

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This image shows a bone bruise pattern consistent with an ACL tear. The pattern of bone bruise on the middle 1/3 of the lateral femoral condyle and posterior 1/3 of the lateral tibial plateau is indicative of ACL tear. It makes sense because the tibia is allowed to subluxate anterior more than usual and make abnormal contact and experiences forces inappropriately.

Viskontas et al. correlated the mechanism of ACL tear with the degree of bone bruising and found that a noncontact mechanism caused more severe bone bruising in both the medial and lateral compartments.

In another MRI review study, Collins et al. found that the presence of bone contusions in the lateral compartment increased the specificity and positive predictive value in determining ACL injury.