Knee hyperextension with typical bone bruises and posterior cruciate ligament tear
Presentation
Hyperextended knee.
Patient Data
Fluid:
Moderate-sized joint effusion. There is disruption of the posterior capsule with increased T2 signal in the posterior adventitial tissues. Fluid signal tracks deep into the medial gastrocnemius muscle.
Bone/marrow:
Bone contusions peripheral lateral femoral condyle near the condylar patellar sulcus and anterior tibia.
Menisci:
A peripheral tear of the medial meniscus is seen involving predominantly the posterior horn. The body and anterior horn of the meniscus is intact. Lateral meniscus is intact.
Ligaments:
Anterior cruciate ligament is intact. The PCL is disrupted at the femoral attachment with diffuse increased T2 signal throughout its course. Medial and lateral collateral ligament complex intact.
Muscles/tendons:
Slight increased T2 signal is seen within the infrapatellar portion of the patellar tendon suggesting a partial tear. The semimembranosus tendon is completely disrupted and retracted. Grade 1 medial gastrocnemius strain is seen with increased T2 signal in the ventral surface of the medial gastrocnemius muscle.
Case Discussion
The bone bruise pattern in this case ("kissing contusions" on the anterior femoral condyle and anterior tibia) is typical of knee hyperextension. The posterior cruciate ligament (PCL) is often torn with this type of injury.
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