Presentation
Chronic knee pain and instability.
Patient Data
No joint effusion. No bone marrow edema.
Absent anterior cruciate ligament. Anterior tibial translation. Straightening of the lateral collateral ligament. Buckling of the posterior cruciate ligament.
Vertical tear through the anterior horn of the medial meniscus. Lateral meniscus is intact.
Linear low-intensity structure running from the anterior horn of the medial meniscus to the lateral aspect of the intercondylar notch, probably an anteromedial meniscofemoral ligament.
Case Discussion
This case has all the features of an ACL rupture except for the acute marrow edema pattern of the pivot-shift mechanism and the ever-present knee joint effusion. The patient had a history of a netball injury 12 months earlier and had suffered an ACL rupture at that time; it was not surgically repaired. The vertical tear of the anterior horn of the medial meniscus may have occurred at the time of initial injury although may be the result of instability.
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