Presentation
Chronic right knee joint pain and restricted movement, no history of trauma.
Patient Data
Evidence of a diffusely thickened ill-defined high signal intensity ACL altering with its normal hypointense fibers giving the characteristic celery stalk appearance, the findings in favor of mucoid degeneration.
Intact posterior cruciate ligaments. Intact menisci; no evidence of a tear.
Evidence of a multilocular cystic lesion, that display low T1/high T2 signal intensity related to the femoral insertion of the ACL measuring 30*20 mm, the findings in favor of an intercondylar notch cyst (ACL ganglion cyst).
Evidence of two focal areas of a cartilage damage and injury of the adjacent subchondral bone involving the lateral articular surface of the tibia, that displays low T1/high T2 signal intensity, the findings in favor of osteochondral defects.
Case Discussion
Features consistent with mucoid degeneration of the ACL. The appearance can mimic acute or chronic interstitial partial tears of the ACL. However, in the case of mucoid degeneration secondary signs of ACL injury are usually absent. Secondary signs include bone bruising, anterior subluxation of the tibia and other ligamentous injuries.
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