Lateral femoral notch sign - anterior cruciate ligament tear

Case contributed by Charlie Chia-Tsong Hsu

Presentation

Left knee trauma.

Patient Data

Age: 40 years
Gender: Male

A split (vertical) fracture of the lateral tibial plateau with probable articular depression.

Deep lateral femoral notch, 1.5 mm. Probable osteochondral fracture of the lateral femoral condyle. 

Moderate knee joint effusion.

Case Discussion

The lateral femoral notch sign is a depression on the lateral femoral condyle, in the context of knee trauma or twisting injury, suggestive of anterior cruciate ligament (ACL) tear. It is due to the impaction of the lateral femoral condyle and the posterior tibial plateau during twisting injury of the knee.

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