ACL mucoid degeration with cystic changes

Case contributed by Dr Fakhry Mahmoud Ebouda

Presentation

Left knee pain and tenderness since long time.

Patient Data

Age: 31 years
Gender: Female

The anterior cruciate ligament is swollen exhibiting altered intensity signal of high T2 signal and intermediate signal in T1WI. Still it showed intact bony attachment and direction of fibers, suggesting mucoid degeneration of the ACL. Small confluent cystic bony lesions are seen in subchondral part of mid upper tibia and mid posterior lower femur near the bony attachment of the ACL exhibiting hyperintense T2 signal and isointense signal in T1W. Simple cystic bony changes related to the mucoid degeneration of the ACL.

Thickened medial supra-patellar plica. Marginal osteophytic formation is seen in the tibio-femoral articulation involving the margin of upper tibia, lower femur, as well as milder osteophytic changes are seen in patello-femoral relation involving the posterior and poles of patella and opposing surface. The joint space is relatively narrowed however the chondral lining is preserved. Moderate joint effusion.  

Case Discussion

Mucoid degeneration of the anterior cruciate ligament has a celery stalk appearance with cystic bony changes near its bony attachment (bony changes related to degenerated ACL). Mild chronic osteoarthritic changes in both patello-femoral and tibio-femoral relation. Moderate joint effusion and medial supra-patellar synovial plica.

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Case information

rID: 48428
Case created: 6th Oct 2016
Last edited: 7th Oct 2016
Inclusion in quiz mode: Included

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