ACL mucoid degeneration with celery stalk sign - pediatric

Case contributed by Dr Ammar Haouimi

Presentation

Restricted motions of the left knee. No history of trauma.

Patient Data

Age: 6 years
Gender: Male

Thickened and ill-defined ACL. The intact fibers are of low signal best seen on T2, separated from each other by higher signal mucinous material, giving the "celery stalk" appearance.

Normal appearance of the menisci, PCL and collateral ligaments.

Case Discussion

MRI features are most consistent with a mucoid degeneration of the ACL.

The pathogenesis of mucoid degeneration of the ACL remains controversial. The possible etiologies include:

  • age-related (senescent) degeneration
  • congenital or acquired synovial tissue entrapment between ACL fibers

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