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MRI and rupture of the anterior cruciate ligament (ACL)

Print Article

Introduction:

The diagnosis of a torn anterior cruciate ligament is clinical. (Fig 1)

MRI of the knee may be requested to confirm the diagnosis, to take stock of associated lesions (meniscal lesions, lateral planes) and to assess the severity of lesions.

clinical diagnosis:

The diagnosis of a torn anterior cruciate ligament (ACL) based on:

The circumstances of the trauma:

- Sports Accident (skiing, football, rugby ....)
- Mechanism of the accident (torsion, drop, shock, giving way ...)
- Perception of a crunch
- Immediate Functional Impotence or not
- Hematoma or knee effusion

The sign of subjective search ACL:

- Knee instability sensation
- D├ęrobement knee

The objective evidence of research ACL:

- Sign of positive Lachman
- Positive anterior drawer
- Rotary jump or jerk positive test

MRI diagnosis:

The normal ACL appears on MRI as a band of hypointense signal, stretched between the femur and the tibia. Its limits are clear.

inserts:

- Top (femur), the most posterior part of the medial aspect of the lateral condyle
- The bottom (tibia) on the pre-spinal surface of the tibia

Consisting of 2 beams

- Anteromedial and posterolateral bundle

The diagnosis of ACL tear MRI is based on direct and indirect signs

morphological:

- No visualization LCAE
- Visualization of the rupture zone

signal:

- Ligament hyperintense on T2 sequences

Orientation:

- Aspect of relaxed LCAE
- Horizontalization LCAE

The indirect signs are:

- Bone contusions (bruising of the outer compartment front part of the lateral condyle and the posterior portion of the lateral tibial tray)
- Anterior subluxation of the tibia external> 7mm
- Verticalisation or deformation of the LCP

Conclusion:

MRI is an efficient examination for the diagnosis of rupture LCAE but the diagnosis must be mainly clinical.
MRI allows the assessment of associated injuries
- Injuries and Meniscal disinsertions
- Attacks collateral Plans
- Bone and osteochondral fractures

Doctor Nicolas LEFEVRE, Doctor Serge HERMAN, Doctor Yves GUGLIELMETTI. - 24 juin 2010.

Conflicts of interest: the author or authors have no conflicts of interest concerning the data published in this article.

News

Imaging of the meniscus

Doctor Nicolas LEFEVRE.

The main objective of this study was to present a synthesis of the current literature in order to provide a useful tool for clinicians in radiological analysis of the meniscus. The magnetic resonance imaging (MRI) is the most accurate and least   invasive for the diagnosis of meniscal tears. This technique has revolutionized the imaging of the knee and has become the "gold standard" for imaging the meniscus. It confirms and characterize the meniscal lesion, type, extension, its possible association with a cyst meniscal extrusion,   assessment of cartilage and subchondral bone.   All anatomical descriptions were clearly illustrated in this articleby MRI,   arthroscopic and / or drawings.   We also described   standard radiography   for differential diagnosis as osteoarthritis. Ultrasound is often used as a diagnostic tool for meniscal pathology. CT arthrography with multiplanar reconstructions can detect some cracks not visible meniscus on MRI. CT arthrography is also useful in case of against-MRI in the postoperative evaluation of meniscal sutures or for analysis   cartilage covering the articular surfaces.

MRI is the most accurate and least invasive method for the diagnosis of meniscal tears.New 3D MRI in three dimensions with isotropic resolution   allow   creating multiplanar reformatted images to obtain from an acquisition in one sectional plane, reconstructions in other spatial planes. 3D MRI should further improve the diagnosis of meniscal tears

This article describes MRI imaging of all meniscal lesions.

Treatment of meniscal tab: Image arthroscopic

By Dr. Nicolas LEFEVRE , Dr. Serge HERMAN , Dr. Yoan BOHU .

The regularization of the tongue of the meniscus is performed arthroscopically. This adjustment is done using small instruments.

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