Double PCL sign

Case contributed by Professor Ali Hekmatnia

Presentation

Trauma

Patient Data

Age: 20 years
Gender: Male
MRI

Bucket handle tear of posterior horn of medial meniscus with absent bow tie sign. Detached fragment of the posterior horn is seen parallel and anteroinferior to the PCL giving double PCL sign.

Loss of normal signal intensity and continuity of ACL fibers suggesting it is torn.

Case Discussion

Double PCL sign is a highly specific indicator of displaced bucket handle meniscal tear. Double PCL sign from a torn medial meniscus can essentially only be seen in patients who have intact ACL. Lateral meniscus bucket handle tear, in the presence of torn ACL give double PCL sign too.

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