Anterior cruciate ligament rupture with medial meniscus bucket handle tear - double PCL sign
Diagnosis certain
Presentation
Knee swelling, pain and locking following knee trauma
Patient Data
Age: 40 years
Gender: Male
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Images show:
- anterior cruciate ligament (ACL) rupture
- bucket handle tear of medial meniscus with double PCL sign
- parameniscal cyst originating from posterior horn medial meniscus near root attachment
- bone bruise in the posterolateral corner of the tibia
- joint effusion
Case Discussion
Typical features of a bucket handle meniscal tear include:
- commoner at medial versus lateral meniscus
- truncation and small size of body of meniscus on coronal images
- "Double PCL sign" on sagittal view
In a suspected case of ACL rupture, the radiologist must:
- evaluate integrity of the ACL on 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 the attachment site of meniscofemoral ligament for subtle evidence of tearing