The double PCL sign appears on sagittal MRI images of the knee when a bucket-handle tear of a meniscus (medial meniscus in 80% of cases) flips medially so that comes to lie anteroinferior to the posterior cruciate ligament (PCL) mimicking a second smaller PCL 1,2.
A double PCL sign from a torn medial meniscus can essentially only seen in patients who have an intact anterior cruciate ligament (ACL) as this is required to prevent the flipped fragment from migrating further laterally, or not aligning parallel to the PCL 1.
In a minority of patients, a lateral meniscus bucket handle tear, in the presence of torn ACL, may also give rise to a double PCL sign.
Identifying a double PCL sign is highly specific (98 - 100%) but of variable sensitivity (27 - 53%) for the detection of displaced bucket handle tears 1.
Associated signs include
- 1. Camacho MA. The double posterior cruciate ligament sign. Radiology. 2004;233 (2): 503-4. doi:10.1148/radiol.2332020945 - Pubmed citation
- 2. Helms CA, Laorr A, Cannon WD. The absent bow tie sign in bucket-handle tears of the menisci in the knee. AJR Am J Roentgenol. 1998;170 (1): 57-61. AJR Am J Roentgenol (abstract) - Pubmed citation
- 3. Lieberman KA. The absent bow tie sign. Radiology. 2000;215 (1): 263-5. Radiology (full text) - Pubmed citation
Synonyms & Alternative Spellings
|Synonyms or Alternative Spelling||Include in Listings?|
|Bucket handle tear||✓|