Anterior cruciate ligament rupture with medial meniscus bucket handle tear (double PCL sign)

Case contributed by Dr Amro Omar


Knee swelling, pain and locking following knee trauma

Patient Data

Age: 40
Gender: Male

Images show:

  • anterior cruciate ligament (ACL) rupture
  • bucket handle tear of medial meniscus with double PCL sign
  • a parameniscal cyst
  • bone bruise in the posteromedial corner of the tibia
  • collateral ligaments injury
  • joint effusion

Case Discussion

  • a bucket handle tear is seen
    • medial > lateral meniscus
    • there will be truncation and small size of body of meniscus on coronal images and "Double PCL sign" on sagittal view
  • in a suspected case of ACL rupture, the radiologist must:
    • evaluate integrity of the ACL on the sagittal, coronal, and axial images
    • look for associated injuries to posterolateral corner structures, medial collateral ligament, or menisci
    • closely inspect the posterior horn lateral meniscus, including degree of lateral extension of attachment site of meniscofemoral ligament for subtle evidence of tearing
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Case information

rID: 34428
Published: 19th Feb 2015
Last edited: 5th Dec 2016
Inclusion in quiz mode: Included

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