Case 38 - 16 year old male with sudden onset right knee pain while playing football
16 year old male with sudden onset right knee pain while playing football.
- This case combines from familiar elements. In additional to a small joint effusion we can see kissing contusions of the lateral femoral condyle and posterolateral tibial plateau. This pattern should immediately raise of suspicion for an anterior crucicate ligament tear.
- Indeed, we have complete discontinuity of the mid-portion of the ACL with surrounding edema indicating an complete tear of the ACL.
- Try to avoid satisfaction of search, there's another important finding, which is commonly seen in the setting of acute ACL injury: a vertical longitudinal tear of the posterior horn of the medial meniscus.
- The tear has a mostly vertical orientation and extends longitudinally through a small portion of the posterior horn. The tear involves the peripheral portion of the meniscus and extends through the superior articular surface.
Vertical longitudinal tears (VLT) most commonly occur in adolescent patients due to trauma; they frequently occur in the setting of an ACL injury. VLT tears by definition extend through to either the superior or inferior articular surface or both. This type of tear most commonly occurs in the peripheral portion of the posterior horn of the medial meniscus. Because the blood supply to the menisci comes from the periphery, more focal VLT tears may heal without surgery.
Accession: CL0077
Study description: MR Knee Right
Case discussion: