Presentation
Longstanding load-dependent medial knee pain with a clinical suspicion of a medial meniscal tear. Now recent knee joint distortion
Patient Data
Findings
Bone
a well-circumscribed lobulated lesion in the lateral femoral metaphysis (~22 x 17 x 11 mm) with internal foci of low signal, 'rings and arcs' characteristics and a narrow transition zone
Joint space
mild to moderate knee joint effusion
Intercondylar region
anterior and posterior cruciate ligaments
Medial compartment
articular cartilage intact
incomplete tear of the posterior horn/corpus of the medial meniscus onto the inferior surface
medial collateral ligament complex intact
Lateral compartment
articular cartilage intact
lateral meniscus inconspicuous
lateral collateral ligament (LCL) torn and surrounded by fluid
popliteus muscle injury
fluid and soft tissue edema of the posterolateral corner structures and joint capsule
Patellofemoral compartment
chondral fissure of the superior medial patellar facet with subchondral changes
distal patellar tendinosis with ossification
quadriceps tendon unremarkable
Impression
posterolateral corner injury with disruption of the lateral collateral ligament (LCL)
incomplete longitudinal tear of the posterior horn and body of the medial meniscus
enchondroma of the lateral femoral metaphysis
Case Discussion
This is an example of a lateral collateral ligament injury of the knee occurring inthe context of a posterolateral corner injury after a recent knee joint distortion in a patient with longstanding medial knee pain. The latter is load-dependent and most likely due to the incomplete longitudinal meniscal tear.
There is also an incidental finding of an enchondroma at a typical location in the femoral metaphysis.
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