Anterior cruciate ligament tear and bucket handle tear of the posterior horn medial meniscus

Case contributed by Dr Heba Abdelmonem

Presentation

Knee twist during playing football

Patient Data

Age: 30 years
Gender: Male

Discontinuity of the femoral attachment of the anterior cruciate ligament (ACL) in keeping with a torn ACL. Abnormal small size and fragmentation of the posterior horn medial meniscus with double PCL sign, on the coronal T2, imaging characteristic of bucket handle tear

Case Discussion

The primary signs of a complete anterior cruciate ligament tear include abnormal interruption, orientation or non-visualization of the ligament. The most important of the secondary signs is the bone contusion, many other secondary signs may include anterior translation of the tibia, meniscal injury as well as a joint effusion. The O'Donoghue unhappy triad of the knee includes torn anterior cruciate and medial collateral ligaments tear together with a torn posterior horn of the medial meniscus.

Both horns are triangular in shape and characterized by very well defined outlines. The posterior horn is always bigger than the anterior horn. If the meniscus demonstrates abnormal shape, it may be interpreted as a meniscal tear or changes after partial meniscectomy.

The bucket handle tear is a displaced longitudinal tear. If there is an appearance of more than two ligament-like structures in the intercondylar notch on the coronal images, it will be a most likely a displaced meniscal fragment.

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Case information

rID: 52015
Published: 18th Mar 2017
Last edited: 15th Mar 2020
Inclusion in quiz mode: Included

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