Medial collateral ligament injury grading

A.Prof Frank Gaillard et al.

Medial collateral ligament (MCL) injuries are graded into three groups on MRI, much in the same way as many other ligaments:

  • grade 1: (minor sprain) high signal is seen medial (superficial) to the ligament, which looks normal
  • grade 2: (severe sprain or partial tear) high signal is seen medial to the ligament, with high signal or partial disruption of the ligament
  • grade 3: complete disruption of the ligament

As a general rule, the MCL is not repaired in the general population if it is an isolated injury. In athletes, grade 3 injuries often require surgical repair 1.

After a few weeks it may appear as a Pellegrini-Stieda syndrome or a Pellegrini-Stieda (PS) lesion, a post-traumatic/post-avulsion calcification of the proximal medial collateral ligament.

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Article information

rID: 10926
Synonyms or Alternate Spellings:
  • MCL injury grading
  • Grading of medial knee collateral ligament injury

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Cases and figures

  • Case 1: grade 1
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  • Bucket handle tear
    Case 2: grade 2
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  • Case 3: grade 3
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  • Case 4: grade 2 with other knee injuries
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  • Case 5: isolated grade 3
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