Presentation
Heavy fall whilst skiing.
Patient Data
Complete ACL tear with a pivot shift bone bruise. The PCL is intact.
The medial meniscus is intact. Complete mid substance MCL tear, with an associated high-grade injury to the posteromedial corner.
Complete transection (radial tear) of the posterior third of the lateral meniscus, the posterior root is intact. Edema surrounds the posterolateral corner in keeping with sprain. High-grade partial thickness tear of the proximal fibular collateral ligament. The other lateral stabilizers are intact.
Partial-thickness fissuring of the lateral patella facet articular cartilage. Complete tear of the tibial aspect of the mPFL.
Large knee joint effusion and extensive intramuscular and subcutaneous edema.
Case Discussion
Hyperacute knee MRI's can be more daunting to report due to the often extensive edema, but using a system/template when reporting will maintain report structure and ensure all areas are reviewed.
ACL injuries often are found with injuries to the posterior knee, and both posterior thirds of the medial and lateral meniscus should be carefully reviewed.
A transected meniscus is a complete radial tear and they can be described with both terms.
3 grades of medial collateral ligament (MCL) injury exist, with grade 3 as shown, representing a complete tear, with discontinuation of the tendon fibers, best appreciated on the axial and coronal sequences.