Anterior cruciate ligament tear with bone bruises suggestive of pivot shift
Presentation
Twisting injury with pain and swelling
Patient Data
Complete full-thickness mid-substance tear of the anterior cruciate ligament with bone bruises of the lateral femoral condyle and posterior lateral tibial plateau indicative of a "pivot shift" mechanism of injury. There is a subchondral impaction fracture adjacent to the lateral femoral condylar bone bruise.
Signal abnormality with questionable surface extension involving the periphery of the posterior horn of the medial meniscus which may represent small nondisplaced oblique peripheral tear.
Partial tear of the anterior fibres of the medial collateral ligament.
Case Discussion
The bone bruise pattern (lateral femoral condyle and posterior lateral tibial plateau ) in this case is typical of a pivot shift mechanism of injury where a flexed knee is subject to a combination of a valgus force and external rotation of the tibia (or internal rotation of the femur) which results in an ACL tear.
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