Soft tissue abnormalities may include injury of ACL or PCL and a meniscal injury along with injury of the popliteal neurovascular structure, complete disruption of the posterolateral complex, gastrocnemius injury [8]. Surgical Strategy for Anterior Tibial Plateau Fractures in Hyperextension Knee Injuries. Orthop Surg. Results: This mechanism of injury involves other soft tissue structures like tears/posterior capsule and arcuate ligament, medial collateral ligament (MCL) and the menisci. The usefulness of the oblique coronal plane in knee MRI on the evaluation of the posterior cruciate ligament. This is a preview of subscription content, access via your institution. PubMed Knee Surg Sports Traumatol Arthrosc. Sports Med. Many patients coming with complain of pain following injury without radiographic evidence of fracture, MRI yields presence of extensive injury marrow which is characterised by marrow oedema and haemorrhage termed as bone bruise. Application of biomechanical approach in MR interpretation helps in effortless assessment of osseous contusion and ligament rupture and mark delicate but significant abnormalities. Epub 2022 Aug 30. PubMed Ryu KN, Jin W, Ko YT, Yoon Y, Oh JH, Park YK, et al. 1989 Sep;27(5):983-1002 To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint. Follow up scan could not be done to establish the presumable diagnosis of bone marrow contusion. . Fornalski S, McGarry MH, Csintalan RP, Fithian DC, Lee TQ. Clin Orthop Relat Res. Disclaimer. Radiology 219(3):800801, Ra H, Kim J, Lee D (2020) Comparative clinical outcomes of anterolateral ligament reconstruction versus lateral extra-articular tenodesis in combination with anterior cruciate ligament reconstruction: systematic review and meta-analysis. This case demonstrates a hyperextension knee injury consisting of. Conclusions: No funding was received to assist with the preparation of this manuscript. 4 Resident, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. AJR Am J Roentgenol. The associated injuries were confirmed by arthroscopy in 12/16 patients. Bone Marrow Signal Alteration in the Extremities. Imaging was done using FOV: 160 mm, slice thickness of 3 mm on Saggital images; FOV: 170 mm, slice thickness of 3 mm on coronal images; FOV: 170 mm, slice thickness on 3.5 mm and axial images with interslice gap of 1.5 mm. Meniscal injury was unrelated to the extent or pattern of bone bruising. 5 0 obj Kirialanis P, Malliou P, Beneka A, Giannakopoulos K. Occurrence of acute lower limb injuries in artistic gymnasts in relation to event and exercise phase. Osteochondral Lesions of the Knee: Differentiating the Most Common The double sulcus sign is a radiographic marker that confers a high probability of ACL injury. Bone contusion is also noted in posterior lip of the medial tibial condyle [8] or medial femoral condyle and medial tibial condyle [7]. {"url":"/signup-modal-props.json?lang=us"}, Knipe H, Yap J, Al Kabbani A, et al. An official website of the United States government. Bone contusion patterns of the knee at MR imaging: footprint of the mechanism of injury. FOIA Acute findings of a joint effusion and posterior tibial plateau contusion are present. <>stream The 32 bone contusions (16 kissing contusions) were located as follows: lateral femoral condyle (n = 14; 8 type I, 6 type II); lateral tibial condyle (n = 9; 3 type I, 1 type II, 5 type III);. Pivot shift injury pattern according to Location of marrow oedema. Age, type of bone bruise, and number of bruises also have prognostic value. Traumatic mechanisms are sometimes too complex or poorly understood which cannot be comprehend [4]. endobj Conclusions: Following knee hyperextension, bone bruising patterns may be associated with cruciate ligament injury. Eur J Radiol. 6 Resident, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. no financial relationships to ineligible companies to disclose. The notch depth of lateral femoral condyle in the experimental group (0.990.56mm) was significantly greater than that in the control group (0.490.28mm) (P<0.05). severe contusions may cause the knee to give out or lock. Rangger C, Kathrein A, Freund MC, Klestil T, Kreczy A. - 134.209.62.117. Lateral-compartment bone contusions in adolescents with intact anterior cruciate ligaments. Emerg Radiol 17(6):435444, Murphy BJ, Smith RL, Uribe JW, Janecki CJ, Hechtman KS, Mangasarian RA (1992) Bone signal abnormalities in the posterolateral tibia and lateral femoral condyle in complete tears of the anterior cruciate ligament: a specific sign? Injury to the Meniscofemoral Portion of the Deep MCL Is Associated with Medial Femoral Condyle Bone Marrow Edema in ACL Ruptures. PDFS Saggital: Bone marrow oedema at Lateral femoral condyle in Clip injury pattern. Xie D, Murray J, Lartey R, Gaj S, Kim J, Li M, Eck BL, Winalski CS, Altahawi F, Jones MH, Obuchowski NA, Huston LJ, Harkins KD, Friel HT, Damon BM, Knopp MV, Kaeding CC, Spindler KP, Li X. Osteoarthritis Cartilage. The knee is a major weight bearing joint that provides mobility and stability during physical activity as well as balance while standing. <> [Table/Fig-10,,1111 and and12]12] show the aetiologies and location for pivot shift injury, Type /Mode of injury among dashboard injury pattern (8 cases) were - Impact from dashboard in 4 cases, fall from bike (2 cases), running downstairs (1 case) and fall while paying cricket (1 case). Asai K, Nakase J, Oshima T, Shimozaki K, Yoshimizu R, Tsuchiya H (2020) Partial resection of the infrapatellar fat pad during anterior cruciate ligament reconstruction has no effect on clinical outcomes including anterior knee pain. In suspected ACL injury, bone marrow contusion may not be necessarily present. Bone marrow oedema is responsible for patient symptoms and may lead to early degenerative changes [7]. Epub 2022 Mar 1. Patterns of bone bruise in knee injury. The most common sites of bone bruising were the anteromedial tibial plateau (48%) and anterolateral tibial plateau (44%). Correlation between contusion pattern in clip injury and type/mode of injury. 36 0 obj 2008;67:5461. A thorough understanding of knee injury patterns and their mechanisms may help achieve more accurate assessment of injuries [8]. These contusions are generally found by magnetic resonance imaging and most cases are associated with ligamentous or menisceal injuries. . Hyperextension of the knee can result when direct force is applied to the anterior tibia while the foot is planted or from an indirect force, such as a forceful kicking. Acrobat Distiller 5.0.5 (Windows) The appearance of kissing contusion in the acutely injured knee in the Movement across knee helps in doing daily activities including walking, sitting, and standing. How To Heal A Knee Contusion - Brandon Orthopedics Radiographic features Five classic bone contusion patterns have been described 1-4: pivot-shift injury valgus stress to flexed and externally rotated knee It can also damage interposed soft tissues, most commonly the articular cartilage and meniscus. Check for errors and try again. 2 Resident, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. The coronal lateral collateral ligament sign in the anterior cruciate ligament-injured knees was observed regardless of the knee laxity based on the quantitative measurements. Table showing Type/Mode of injury in pivot shift injury. endobj FOIA PubMed Tensile load can cause ligament and tendon tears as well as avulsion fracture. Am J Sports Med. Book an Appointment. Bone bruise represents as acute, occult microfractures of subchondral trabecular bone with subsequent haemorrhage, oedema and hyperemia. Extensive posterior capsular edema in keeping with a hyperextension injury. Bone marrow contusions are frequently identified at magnetic resonance imaging after an injury to the musculoskeletal system, and the mechanism of injury can be determined by studying the distribution of bone marrow edema, which enables one to predict with accuracy the specific soft-tissue abnormalities that are likely to be present. The presence of a double sulcus showed significant association with anteromedial kissing contusions (OR = 7.8, p = 0.03). Radiology. BMC Musculoskelet Disord 16:217, Article Knee Surg Sports Traumatol Arthrosc. Please enable it to take advantage of the complete set of features! Google Scholar. XZ contributed to part of the statistics of the article. 2000;28:6637. T2 Axial: Bone marrow oedema in Inferiomedial aspect of patella and lateral femoral condyle in lateral patellar dislocation. Perin B, Nardacchione R, Bonaga S, Angelini F, Girotto A, Giovagnoni A, et al. Archives of Orthopaedic and Trauma Surgery A cross-sectional study was done on all patients referred to Krishna Hospital, Karad for MRI knee with history of recent (< 6 weeks) knee injury. Kapelov RS, Terris LM, Bradley WG, Bucciarelli NR, Murakami DM, Mullin WJ, et al. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Other associated injury in ACL (87.5%), Medial meniscus (50 %) and lateral meniscus (75%). 2004;32:16817. Part of Springer Nature. Epub 2022 Apr 12. Graf BK, Cook DA, De Smet AA, Keene JS. Chi-square = 1.926, p =0.3817 i.e. Background: Bone contusions are often identified at magnetic resonance imaging (MRI) in the acutely injured knee. Knee Surg Sports Traumatol Arthrosc 23(8):22502258, Hoffelner T, Pichler I, Moroder P et al (2015) Segmentation of the lateral femoral notch sign with MRI using a new measurement technique. Texas Health Care Imaging | Radiology Clinic in Brownsville, TX 8600 Rockville Pike Application of valgus load to the knee in various degree of flexion combined with external rotation of the tibia or internal rotation of the femur lead to pivot shift injury resulting in disruption of Anterior Cruciate Ligament (ACL). The oedema pattern & suspected type/mode of injury on basis of MRI were then correlated with detailed patients history on mode of injury. Bone marrow oedema is usually most prominent in the lateral femoral condyle secondary to the direct blow, whereas a second smaller area of oedema in the medial femoral condyle secondary to avulsive stress to the MCL. Language links are at the top of the page across from the title. Objective: To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint. 1993 Mar-Apr;21(2):220-3 In our study pivot shift pattern is noted in 78 cases (56.5%). Bookshelf Most common type/mode of injury in clip injury pattern in fall from two wheeler in 26 cases (66.7%). 2003;37:1379. Our results therefore suggest that kissing contusions are more common following knee hyperextension than in other forms of knee injury and predominantly affect the medial side. In six cases (4.3%) no pattern of bone marrow contusion could be explained and was categorized as unclassified pattern. 2023-05-01T23:01:26-07:00 Bone contusions were diagnosed in 71 cases (27.8%); 55 (22.5%) were identified as single contusions and 16 (6.3%) as kissing contusions. Meyer EG, Baumer TG, Haut RC. doi: 10.2106/JBJS.OA.21.00069. 2022 Dec;30(12):1647-1657. doi: 10.1016/j.joca.2022.08.006. Comparison of magnetic resonance imaging for patients with a - LWW Google Scholar. KIS Imaging is the nations largest direct contracting imaging network with over 2,600 providers covering all major imaging needs: MRI, CT and PET. As a library, NLM provides access to scientific literature. PubMedGoogle Scholar. National Library of Medicine Arch Orthop Trauma Surg 140(12):20132020, Article Inpatient imaging services are available 24/7. There has been limited investigation to subdividing the bone contusion model in the medial and lateral directions of the tibial plateau and the . J Biomech Eng. Bretlau T, Tuxe J, Larsen L, Jrgensen U, Thomsen HS, Lausten GS. from publication: The appearance of kissing contusion in the acutely injured knee in the athletes | Bone contusions are often identified at magnetic resonance imaging (MRI) in the acutely. In current study unclassifiable injuries pattern was noted in 6 cases. DOI: 10.1148/radiographics.20.suppl_1.g00oc19s135 PMID: 11046168. 2013 Aug;41(8):1801-7. doi: 10.1177/0363546513490649. Clin Imaging. Bone contusion patterns of the knee at MR imaging: footprint of the For KC, the corresponding values were 36.6% and 99.4%, respectively. Oedema or interisital fluid within marrow extracellular space similar to free fluid shows long T1 and T2 decay characteristics and appear hypointense on T1 and hyperintense on T2W. Unauthorized use of these marks is strictly prohibited. Anterior tibial plateau oedema and rupture of the posterior capsule predicted cruciate ligament injury [OR=10.5 (p=0.02) and 24.0 (p=0.001) respectively]. Learn more about Institutional subscriptions. Before Bone Contusion Patterns of the Knee at MR Imaging: Footprint of the
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