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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.
The diagnosis of a torn anterior cruciate ligament (ACL) based on:
- 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
- Knee instability sensation
- Dérobement knee
- Sign of positive Lachman
- Positive anterior drawer
- Rotary jump or jerk positive test
The normal ACL appears on MRI as a band of hypointense signal, stretched between the femur and the tibia. Its limits are clear.
- 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
- Anteromedial and posterolateral bundle
morphological:
- No visualization LCAE
- Visualization of the rupture zone
- Ligament hyperintense on T2 sequences
- Aspect of relaxed LCAE
- Horizontalization LCAE
- 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
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