ACL and meniscal tears

Case contributed by Dr Dai Roberts


Acute twisting injury.

Patient Data

Age: 30 years
Gender: Male

Complete ACL with a pivot shift bone bruise. 

Complex tear of the medial meniscus posterior third, which includes a RAMP lesion.

Near-complete transection of the lateral meniscus posterior third, with the large fragment attached to the root, flipped into the intercondylar notch.

Intact but sprained fibular-collateral ligament.

Case Discussion

Bone bruise patterns in knee injuries will aid in the interpretation of knee MRI. The posterior thirds, also called the posterior horns, of the meniscus are important areas to review in ACL injuries, and include Wrisberg rip tears and RAMP lesions.  

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