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Other structures are injured less frequently and have weaker associations with bone bruise distribution. Chi-square: 41.961 and p <0.001 suggests that clip injury was significantly high in fall from two wheeler and pivot shift injury was significantly higher in sports related injury. endobj 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. Minor focus of edema in the anterior aspect of the lateral femoral condyle. Snearly WN, Kaplan PA, Dussault RG. Department of Radiology, Wilford Hall Medical Center, 759th MDTS/MTRD, 2200 Bergquist Dr, Ste 1, Lackland AFB, TX 78236-5300, USA. Google Scholar; . MR diagnosis of Bone contusion of the knee: Comparison of coronal T2 weighted Fast spin echo with fat saturation and fast spin echo STIR images with conventional STIR images. 1993;21:2203. Following knee hyperextension, bone bruising patterns may be associated with cruciate ligament injury. The classic bone contusion includes involvement of the antero-lateral aspect of the lateral femoral condyle and the inferomedial aspect of the patella. Furthermore, it is anterior tibial oedema rather than the presence of kissing lesions than predicts cruciate ligament injury (OR = 10.5, p = 0.02). -, Radiology. ACL tears are classified into three grades: Grade I ACL tears represent intraligamentous injury without a change in ligament length. 1996 Jan;198(1):205-8 Unclassified injury pattern in 6 cases with type /mode of injury and location of bone marrow contusion. In addition to trauma, marrow oedema can be seen in a broad spectrum of entities, including infection, transient osteoporosis of the hip bone marrow, and neoplasm demonstrates relatively hyperintense T2 and hypointense T1 signal, but the clinical history and location of injury typically allows the correct diagnosis to be made [2]. Tensile load can cause ligament and tendon tears as well as avulsion fracture. Bone bruises: MR characteristics and histological correlation in the young pig. %PDF-1.4 % Hong CK, Hoshino Y, Watanabe S, Nagai K, Matsushita T, Su WR, Kuroda R. Knee Surg Sports Traumatol Arthrosc. ;S'XhM. Radiology. Assessment with magnetic resonance, correlated with arthroscopy. . Diagnostic value of the lateral femoral notch sign and kissing contusion in patients with anterior cruciate ligament injuries: a case-control study. Clipboard, Search History, and several other advanced features are temporarily unavailable. Contusions of both surfaces of the joint are known as kissing contusions. This mechanism of injury involves other soft tissue structures like tears/posterior capsule and arcuate ligament, medial collateral ligament (MCL) and the menisci. PubMedGoogle Scholar. Whilst anterolateral tibial plateau oedema strongly predicted PCL injury [OR=26.0, p=0.003], ACL injury was associated with a variable pattern of bone bruising. Ryu KN, Jin W, Ko YT, Yoon Y, Oh JH, Park YK, et al. 2004-09-01T13:26:27Z Waiving out of pocket expenses incentivizes your members to use the KISx network resulting in savings for both planandmember. 2006;238:85362. Bone contusions of the posterior lip of the medial tibial plateau (contrecoup injury) and associated internal derangements of the knee at MR imaging. Extensive posterior capsular edema in keeping with a hyperextension injury. 1989 Jun;171(3):761-6 This pattern is thought to result resolution from contrecoup forces in the medial compartment at the forced valgus forces. Knee 27(2):414419, Yoon JP, Chang CB, Yoo JH et al (2010) Correlation of magnetic resonance imaging findings with the chronicity of an anterior cruciate ligament tear. <> Twenty-five patients were identified (median time from injury to MRI = 24 days). eCollection 2021 Oct-Dec. Liu ZY, Zhang JL, Zhang T, Cao Q, Zhao JC, Li EQ, Shen QJ, Zhao BC, Zheng YC, Chen Y. Orthop Surg. Conventional radiograph evaluation of skeleton following trauma divides injury into presence or absence of fracture. A 30-year-old woman with acute knee injury. Objective: LXC designed the study and was responsible for the paper. This is a preview of subscription content, access via your institution. PubMed Central Sports Health. Br J Sports Med 42(6):394412, Saxena A, Ray B, Rajagopal K, DSouza A, Pyrtuh S (2012) Morphometry and magnetic resonance imaging of anterior cruciate ligament and measurement of secondary signs of anterior cruciate ligament tear. 2012;2 (5): 398-402. A deeper notch often indicates a more complex knee injury. and kissing contusions of the lat-eral femoral condyle and medial tibial pla . Clin Radiol. Correlation between various pattern of bone marrow oedema and type/mode of injury. MRI of affected knee joint was done as per imaging protocol and images stored in compact disc. Conclusions: Accessibility official website and that any information you provide is encrypted Unable to load your collection due to an error, Unable to load your delegates due to an error. 2019 Nov;27(11):3633-3637. doi: 10.1007/s00167-019-05490-7. Emerg Radiol 2:129134, Article Hong CK, Lin YJ, Cheng TA, Chang CH, Hsu KL, Kuan FC, Su WR. uuid:a4a67e17-1dd1-11b2-0a00-340827bd7200 Am J Sports Med. An official website of the United States government. 2014;24:14817. Correlation between various pattern of bone marrow oedema and type/mode of injury are shown in [Table/Fig-17]. Reflecting presence of increased free water oedema, appears hyperintense on inversion recovery and fat suppressed images and shows increase diffusivity on Diffusion weighted images [10]. bubble tea consumption statistics australia. 1993 Mar-Apr;21(2):220-3 MeSH Epub 2022 May 3. The .gov means its official. Meyer EG, Baumer TG, Haut RC. Unable to process the form. Am J Sports Med. Become a Gold Supporter and see no third-party ads. Although patients often present to the emergency department with acute knee pain and hemarthrosis, spontaneous reduction frequently occurs, and half of cases are unsuspected clinically. This was comparable to study conducted by Kirsch et al., in who reported transient lateral patellar dislocation in 2% cases with acute knee injuries and bone marrow contusion is noted in lateral femoral condyle in 81% and contusion in patella in 19% cases [15]. Diagnostic value of the lateral femoral notch sign and kissing contusion in patients with anterior cruciate ligament injuries: a casecontrol study. 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); medial tibial condyle (n = 7; 2 type I, 5 type III); medial femoral condyle (n = 2; both type I). Sanders TG, Medynski MA, Feller JF et-al. 33 0 obj Epub 2013 Jun 6. Background: The location and severity of tibiofemoral bone contusions in magnetic resonance imaging scans in patients with acute non-contact anterior cruciate ligament injuries can reflect the primary mechanisms of anterior cruciate ligament injuries. The site is secure. 98 0 obj Table showing Type/Mode of injury in pivot shift injury. 2023-05-01T23:01:26-07:00 Before PubMed Kirsch MD, Fitzgerald SW, Friedman H, Rogers LF. Boks SS, Vroegindeweij D, Koes BW, Hunink MG, Bierma-Zeinstra SM. Radiographics : a Review Publication of the Radiological Society of North America, Inc , 01 Oct 2000, 20 Spec No: S135-51. 4. Materials and methods: 1989 Mar;170(3 Pt 1):823-9 see full revision history and disclosures, posterior soft tissue injuries involving the knee joint capsule, fibular attachment of soleus and distal semimembranosus tendon. Over 2600 credentialed providers acrosstheUS. 2015;49:145260. PubMed Skeletal Radiology After knee injury, bone marrow oedema is frequently subchondral in location and may be associated with either trabecular or cortically based lines [4]. Patel SA, Hageman J, Quatman CE, Wordeman SC, Hewett TE. Arch Orthop Trauma Surg 143, 927934 (2023). Lianxu Chen. 2023 Feb;143(2):927-934. doi: 10.1007/s00402-022-04366-9. Radiology 193(3):835840, Grimberg A, Shirazian H, Torshizy H, Smitaman E, Chang EY, Resnick DL (2015) Deep lateral notch sign and double notch sign in complete tears of the anterior cruciate ligament: MR imaging evaluation. Skeletal Radiol 47, 173179 (2018). The double sulcus sign is a radiographic marker that confers a high probability of ACL injury. Radiol Med. Google Scholar, Kanakamedala AC, Burnham JM, Pfeiffer TR et al (2018) Lateral femoral notch depth is not associated with increased rotatory instability in ACL-injured knees: a quantitative pivot shift analysis. Chin YC, Wijaya R, Chong le R, Chang HC, Lee YH. Expansive network access, savings and no red tape An absolute win-win foreveryone! In this case, patient has had a hyperextension external rotation injury of the knee as evidenced by the kissing bone marrow contusions in the anterior aspect of the lateral femoral condyle (LFC) and the lateral tibial plateau. doi: 10.2106/JBJS.OA.21.00069. Correspondence to For outpatient testing, Valley Regional Imaging is open Monday to Friday from m 8 a.m. to 8 p.m. Saturday hours are available for obstetrics (OB) and CAT Scans only from 8 a.m. to noon. Kaplan PA, Gehl RH, Dussault RG, Anderson MW, Diduch DR. -, Radiology. official website and that any information you provide is encrypted Before 2011;68:7626. NAME, ADDRESS, E-MAIL ID OF THE CORRESPONDING AUTHOR: Dr. Ashish Garg, A-4, Ashok Nagar, Mandoli Road, Shahdara, Delhi-110093, India. Knee Surg Sports Traumatol Arthrosc 26(5):13991405, Lodewijks P, Delawi D, Bollen TL, Dijkhuis GR, Wolterbeek N, Zijl JAC (2019) The lateral femoral notch sign: a reliable diagnostic measurement in acute anterior cruciate ligament injury. The KIS Imaging program was designed to direct patient care, through a concierge service, in which employees and employers can realize up to an 80% savings on all major imaging. -, Am J Sports Med. HHS Vulnerability Disclosure, Help The clip injury results in a prominent area of edema involving the lateral femoral condyle and a smaller area of edema involving the medial femoral condyle. 5 0 obj PDFS Coronal: Bone marrow oedema at Medial femoral condyle and proximal tibia. The most common sites of bone bruising were the anteromedial tibial plateau (48%) and anterolateral tibial plateau (44%). . Contusion is seen in the anterior aspect of the distal femur and proximal tibia or located in medial femoral and tibial condyle (valgus force applied). The pattern of bone bruise in knee injuries (a.k.a. In current study unclassifiable injuries pattern was noted in 6 cases. Radiographic features Five classic bone contusion patterns have been described 1-4: pivot-shift injury valgus stress to flexed and externally rotated knee Bone contusion of knee: Increase lesion detection with fast spin echo MR Imaging with spectroscopic Fat saturation. HHS Vulnerability Disclosure, Help Article 1993;189:9014. Incidence and location of bone bruises after acute posterior cruciate ligament injury. 5 out of 8 patients with a double sulcus on the lateral radiograph had ACL injury. judge timothy kenny political affiliation. Elsevier Health Sciences. 2023 Springer Nature Switzerland AG. Mechanism of traumatic knee injuries and MR findings. AJR Am J Roentgenol. Whilst anterolateral tibial plateau oedema strongly predicted PCL injury [OR = 26.0, p = 0.003], ACL injury was associated with a variable pattern of bone bruising. endobj Fornalski S, McGarry MH, Csintalan RP, Fithian DC, Lee TQ. They found that all the lesions in one patient do not heal at exactly the same speed. Study was conducted between May 2014 to September 2015 with a sample size of 200 patients. Application of biomechanical approach in MR interpretation helps in effortless assessment of osseous contusion and ligament rupture and mark delicate but significant abnormalities. Google Scholar. The spectrum of damage includes stretching, partial tearing, and complete rupture [4]. Bone marrow contusion was noted in 71 cases out of 255 cases (27.8%). The usefulness of the oblique coronal plane in knee MRI on the evaluation of the posterior cruciate ligament. Part of Springer Nature. Sanders TG, Medynski MA, Feller JF, Lawhorn KW. There were high rates of injury to the posterior capsule (52%), ACL (40%) and PCL (40%) but lower rates of injury to the menisci (20%), medial and lateral collateral ligaments (16%) and posterolateral corner (16%). Objective: To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint. 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]. Transient lateral patellar dislocation: diagnosis with MR imaging. 1989 Sep;27(5):983-1002 Background: Bone contusions are often identified at magnetic resonance imaging (MRI) in the acutely injured knee. J Orthop Surg Res. [12] PubMedGoogle Scholar. Am J Sports Med. <> Learn more about Institutional subscriptions. Kissing contusion is a significant injury often associated with ligamentous or menisceal injuries. 1 Professor and HOD, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. Knee Surg Sports Traumatol Arthrosc. Biomechanical Approach to MRI of Acute Knee Injuries. This study was approved by the ethical committee of Beijing Tsinghua Changgung Hospital (No. Eight of the kissing contusions were associated with anterior cruciate ligament tears, three with menisceal tears, four were isolated lesions, and one was delayed, following a menisceal tear. PubMed Central 2021 Nov 11;6(4):e21.00069. A knee contusion can usually be treated . 5 Resident, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. Contusions of both surfaces of the knee joint are known as kissing contusions. Location of bone bruises and other osseous injuries associated with acute grade III isolated and combined posterolateral knee injuries. Am J Sports Med 28(1):6873, Gentili A, Seeger L, Yao L, Do H (1994) Anterior cruciate ligament tear: indirect signs at MR imaging. The clip injury is a contact injury that occurs after a pure valgus stress is applied to the knee while the knee is in a state of mild flexion (i.e. Google Scholar, Wierer G, Simetinger T, Hudelmaier M, Moroder P, Hoffelner T (2020) Fate of the lateral femoral notch following early anterior cruciate ligament reconstruction. A knee contusion is a bruised knee. Meniscal injury was unrelated to the extent or pattern of bone bruising.

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