Presentation
Knee injury at sport.
Patient Data
No cortical fracture identified. Deep lateral femoral notch on the lateral. No effusion or lipohemarthrosis. Skeletal alignment within normal limits.
Pivot shift mechanism of injury with osteochondral impaction fracture of the lateral femoral condyle and marrow edema of both the posteromedial and posterolateral tibial plateau.
Large joint effusion. Full-thickness ACL tear. PCL intact. Posterior horn medial meniscus tear. Lateral meniscus intact. Hyperintensity surrounds the arcuate ligament in keeping with a posterolateral corner injury. Lateral collateral ligament is intact. Grade 2 medial collatera\ ligament injury.
Case Discussion
The deep lateral femoral notch sign describes a depression on the lateral femoral condyle at the terminal sulcus and when deep suggests an osteochondral impaction fracture when seen on x-ray. It is associated with ACL tears.
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