2023 Springer Nature Switzerland AG. Article Zeiss J, Paley K, Murray K, Saddemi SR. Federal government websites often end in .gov or .mil. Patel SA, Hageman J, Quatman CE, Wordeman SC, Hewett TE. This injury most commonly occurs when the knee strikes against the dashboard during an automobile accident or fall against the ground on flexed knee. Unclassified injury pattern in 6 cases with type /mode of injury and location of bone marrow contusion. Knee Surg Sports Traumatol Arthrosc. Although bone marrow oedema is nonspecific and has a similar appearance in inflammatory and neoplastic disorders, a traumatic cause is usually obvious on the basis of the clinical history, location of bone marrow oedema and the presence of other trauma related findings. Prognosis is particularly influenced by the presence of osteoarthritis. endobj National Library of Medicine 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]. Unable to process the form. Furthermore, it is anterior tibial oedema rather than the presence of kissing lesions than predicts cruciate ligament injury (OR = 10.5, p = 0.02). A knee contusion can usually be treated . J Bone Joint Surg Am. 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]. Epub 2021 May 11. Rangger C, Kathrein A, Freund MC, Klestil T, Kreczy A. 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]. Radiology 184(3):855858, Dimitriou D, Reimond M, Foesel A et al (2021) The deep lateral femoral notch sign: a reliable diagnostic tool in identifying a concomitant anterior cruciate and anterolateral ligament injury. Calvo-Gurry M, Hurley ET, Withers D, Vioreanu M, Moran R. Knee Surg Sports Traumatol Arthrosc. In patients with bone marrow contusion, 14 were women (10.1%) and 124 were men (89.9%). 4 Resident, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. Sahoo K, Garg A, Saha P, Dodia JV, Raj VR, Bhairagond SJ. 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%). -, Radiology. On analysing the bone marrow contusion pattern, type/mode can be determined in most of cases. Imaging Services | HCA Valley Regional Medical Center | Valley Regional -. High signal well within the intercondylar notch with a partial-thickness tear inferiorly of the femoral insertion of the posterior cruciate ligament (best see on the coronal sequence). The most common sites of bone bruising were the anteromedial tibial plateau (48%) and anterolateral tibial plateau (44%). J Orthop Surg Res. and transmitted securely. Case study, Radiopaedia.org (Accessed on 02 May 2023) https://doi.org/10.53347/rID-83381. Magnetic Resonance Imaging of Sports injuries of knee. By directing imaging . The saggital plane was primarily used to evaluate the bone marrow oedema which was confirmed on coronal images. Terzidis IP, Christodoulou AG, Ploumis AL, Metsovitis SR, Koimtzis M, Givissis P. The appearance of kissing contusion in the acutely injured knee in the athletes. Arch Orthop Trauma Surg 128(11):13131316, Terzidis IP, Christodoulou AG, Ploumis AL, Metsovitis SR, Koimtzis M, Givissis P (2004) The appearance of kissing contusion in the acutely injured knee in the athletes. 1996;198:2058. 2 Resident, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. Bisson LJ, Kluczynski MA, Hagstrom LS, Marzo JM. Mandalia V, Fogg AJB, Chari R, Murray J, Beale A, Henson JHL. Bretlau T, Tuxe J, Larsen L, Jrgensen U, Thomsen HS, Lausten GS. *no pattern of bone marrow contusion could be explained as per the classification. The primary aim of the study was to identify imaging pattern in bone marrow oedema and to correlate the pattern of bone marrow oedema retrospectively with type of knee injury from clinical history. Kim-Wang SY, Spritzer CE, Owusu-Akyaw K, Coppock JA, Goode AP, Englander ZA, Wittstein JR, DeFrate LE. Injury in PCL is seen in all the cases. In impaction, the compressive force directly strikes cortical bone and is dissipated into trabecular bone [4]. Transient lateral patellar dislocation: diagnosis with MR imaging. Knee Surg Sports Traumatol Arthrosc 27(2):659664, Miller LS, Yu JS (2010) Radiographic indicators of acute ligament injuries of the knee: a mechanistic approach. 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. Kaplan PA, Gehl RH, Dussault RG, Anderson MW, Diduch DR. Inclusion in an NLM database does not imply endorsement of, or agreement with, 4. The usefulness of the oblique coronal plane in knee MRI on the evaluation of the posterior cruciate ligament. Biomechanical Approach to MRI of Acute Knee Injuries. At the time the case was submitted for publication Henry Knipe had no recorded disclosures. Objective: To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint. Graf BK, Cook DA, De Smet AA, Keene JS. PubMed Park HJ, Lee SY, Chung EC, Rho MH, Ahn JH, Kim M, et al. Terzidis et al., 20 conducted a study on acute knee injuries in 255 athletes with acutely injured knees, 219 MRIs were done within the first month after the injury and 36 within two to four months [13]. {"url":"/signup-modal-props.json?lang=us"}, Knipe H, Yap J, Al Kabbani A, et al. By applying a biomechanical approach in MR interpretation, it is possible to detect lesions like ligament rupture and osseous contusion, to predict subtle but it might overlook important abnormalities. MeSH CAS Bone bruises: MR characteristics and histological correlation in the young pig. Posterior tibial bone bruising associated with posterior-medial meniscal tear in patients with acute anterior cruciate ligament injury. The authors declare that they have no conflict of interest. Semin Ultrasound CT MR. 1994 Oct;15(5):396-409. doi: 10.1016/s0887-2171(05)80006-x. endobj Objective: Out of 200 patients, 32 were women (16%) and 168 men (84%). Knee joint is one of strongest joint in body and allows transmission of body weight to leg. Article Bone marrow contusion showed five patterns (according to Sanders classification) i.e., Clip injury in 39 cases (28.3%), Pivot shift injury in 78 cases (56.5%), Dashboard injury in eight cases (5.8%), Hyperextension injury in four cases (2.9%), Lateral patellar dislocation in three cases (2.2%). In this study, patients with history of knee injury <6 weeks were considered as recent knee injuries. Before Bone Marrow Edema Injury Patterns in the Pediatric Knee: An MRI Study. 1998;69:2914. Hong CK, Hoshino Y, Watanabe S, Nagai K, Matsushita T, Su WR, Kuroda R. Knee Surg Sports Traumatol Arthrosc. PDFS Saggital: Bone marrow oedema at Lateral femoral and posterolateral tibial plateau in Pivot shift injury. 2011 Aug 17;93(16):1510-8. doi: 10.2106/JBJS.J.01320. PubMed Epub 2013 Jun 6. Pivot shift pattern is most common contusion pattern and the most common type/mode of sports related injury. Bone contusion and associated meniscal and medial collateral ligament injury in patients with anterior cruciate ligament rupture. This site needs JavaScript to work properly. The magnitude of the force is a major determinant of the imaging findings. official website and that any information you provide is encrypted Bethesda, MD 20894, Web Policies Therefore, an influence by the number of bone bruises on healing time was marked; the higher the number, the more likely that there will be one slowly resolving lesion. 2000;28:6637. Tax calculation will be finalised during checkout. Over the lifetime, 3 publication(s) have been published within this topic receiving 31 citation(s). bone contusion) can give clues for the mechanism and associated injuries. Assessment with magnetic resonance, correlated with arthroscopy. <> Am J Sports Med. Language links are at the top of the page across from the title. Ryu KN, Jin W, Ko YT, Yoon Y, Oh JH, Park YK, et al. Sports Med. Hyperextension knee injury | Radiology Case | Radiopaedia.org 33 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/TrimBox[57.25999 58.11 666.34 848.69299]/Type/Page>> of knee injury in pediatric patients. A prospective study of the association between bone contusion and intra-articular injuries associated with acute anterior cruciate ligament tear. The oedema pattern & suspected type/mode of injury on basis of MRI were then correlated with detailed patients history on mode of injury. Oedema is seen at the anterior aspect of the tibia and, occasionally, at the posterior surface of the patella [8]. The diagnostic outcome of LFNS was not in agreement with that of KC, as there was a poor coincidence according to the Kappa coefficient (Kappa=0.155<0.4, P=0.035). <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/TrimBox[57.25999 58.11 666.34 848.69299]/Type/Page>> 8600 Rockville Pike Perin B, Nardacchione R, Bonaga S, Angelini F, Girotto A, Giovagnoni A, et al. BMC Musculoskelet Disord 16:217, Article Kessler R, Campbell S, Wong D, Mansfield LB. Mechanism of traumatic knee injuries and MR findings. 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. Herbst E, Hoser C, Tecklenburg K, Filipovic M, Dallapozza C, Herbort M, et al. When femur rotates internally on a fixed tibia on the flexed knee; contraction of the quadriceps occurs, leading to lateral dislocation of the patella out of the trochlear groove [8,14]. In present study clip injury pattern is noted in 39 cases (28.6%). -, Radiology. In our study pivot shift pattern is noted in 78 cases (56.5%). PDF Diagnostic value of the lateral femoral notch sign and kissing Call Us Today! On MR images, trabecular contusion has the appearance of bone marrow oedema. Results: 1996 Sep;(330):133-42 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. After knee injury, bone marrow oedema is frequently subchondral in location [4]. This case demonstrates a hyperextension knee injury consisting of. 2003;37:1379. Diagnostic value of the lateral femoral notch sign and kissing contusion in patients with anterior cruciate ligament injuries: a case-control study. The appearance of kissing contusion in the acutely injured knee in the Bethesda, MD 20894, Web Policies Resulting bone contusion pattern will be present in the posterior aspect of the lateral tibial plateau and midportion of the lateral femoral condyle near the condylopatellar sulcus. In this study, inclusion criteria were acute knee injury only in athletes while in our study there were no such selection criteria. endstream Other 2 cases (50%) are hyperextension with valgus component and kissing contusion at medial aspect of proximal tibia and distal femur caused due to kicking while playing football. 3. This site needs JavaScript to work properly. Part of Springer Nature. 6 Resident, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. "Kissing contusions," a commonly seen secondary sign of ACL injury caused by the previously mentioned pivot-shift mechanism of injury, occur on the posterior aspect of the tibial plateau and the mid to anterior aspect of the femoral condyle (Figure 4). Analytical Services; Analytical Method Development and Validation Am J Sports Med. Skeletal Radiology Background: XZ contributed to part of the statistics of the article. Study of imaging pattern in bone marrow oedema in MRI in recent knee injuries and its correlation with type of knee injury. 2011 Aug 17;93(16):1510-8. doi: 10.2106/JBJS.J.01320. Materials and methods: HHS Vulnerability Disclosure, Help Texas Health Care Imaging is a radiology clinic located in Brownsville, TX. Age, type of bone bruise, and number of bruises also have prognostic value. Br J Sports Med 38(5):592596, Article The appearance of kissing contusion in the acutely injured knee in the Follow-up of occult bone lesions detected at MR imaging: systematic review. We have included all the patients coming with acute knee injuries irrespective of type/mode of injury. Soft tissue injury associated with dash board injury includes PCL and posterior joint capsule. and transmitted securely. Bone marrow contusions are frequently identified at magnetic . This mechanism of injury involves other soft tissue structures like tears/posterior capsule and arcuate ligament, medial collateral ligament (MCL) and the menisci. Patient demographics, the clinical presentation, and the role of trauma are critical for . Associated Soft tissue injuries include ACL and medial meniscus [8]. 1997;93(12):404. 5 out of 8 patients with a 'double sulcus' on the lateral radiograph had ACL injury. 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. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. 2011;133:011012. ;S'XhM. Waiving out of pocket expenses incentivizes your members to use the KISx network resulting in savings for both planandmember. Clinical outcome of isolated subcortical trabecular fractures (bone bruise) detected on magnetic resonance imaging in knees. The posteromedial corner of the knee is a capsuloligamentous complex in the posterior aspect of the medial compartment. LXC designed the study and was responsible for the paper. Vojnosanit Pregl. In present study transient dislocation of patella pattern is noted in 3 cases (2.2%). It is a rare (6.3% in this series) but significant injury, often associated with ligamentous or menisceal tears. Due to superior ability to produce high resolution images with exquisite soft tissue contrast, MRI is the modality of choice for evaluation of bone marrow. The pattern of bone bruise in knee injuries (a.k.a. Results are comparable to the study conducted by Kaplan et al., in which bone marrow contusion at posterior lip of medial tibial condyle was seen in 25 out of 215 cases (11.6%) and contusion in lateral compartment was noted in 24 out of 25 cases (96%) and contusion at medial femoral condyle was seen in 5 in 25 cases (20%) [7]. Ciuffreda P, Lelario M, Milillo P, Vinci R, et al. Texas Health Care Imaging has been registered with the National Provider Identifier database since May 25, 2021 and its NPI number is 1053986786 (certified on 05/25/2021). 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. Thank Professor Zhuozhao Zheng and my girlfriend Danyu Chen for their advice and help on this study. PubMed Boks et al., conducted a study of the natural course of bone bruises in posttraumatic knees and to describe possible determinants of this course and concluded that Median healing time of bone bruises is 42.1 weeks [5]. 2007;41 Suppl 2:98-104. -, Radiol Clin North Am. Extensive posterior capsular edema in keeping with a hyperextension injury.