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ACL tear, Wrisberg rip and posterolateral corner injury

Case contributed by Luu Hanh
Diagnosis almost certain

Presentation

Left knee trauma

Patient Data

Age: 30 years
Gender: Male

ACL demonstrates swelling, fiber discontinuity, high signal on T2/PD fat sat consistently with a completed ACL tear.

A longitudinal vertical tear of the lateral meniscus's posterior horn extends from the attachment of the ligament of Wrisberg in keeping with Wrisberg rip. 

The proximal lateral collateral ligament and popliteus tendon show a high signal on PD fat sat, surrounded by a joint fluid with adjacent bone marrow edema suggestive of a posterolateral corner injury.

Edema surrounds the medial collateral ligament with bone marrow edema at the medial condyle insertion site compatible with MCL tear grade 1.

A chondral fragment is visible in the Hoffa fat pad with edema and fluid. 

Knee joint effusion. 

Case Discussion

This case insulates the multiple knee injury: ACL tear, Wrisberg rip, posterolateral corner injury, and MCL tear. In the ACL tear, anterior tibial translation occurs, resulting in traction of the ligament of Wrisberg against the PCL and tearing a longitudinal vertical lateral meniscus.

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