Medial collateral ligament injury with lateral patellar instability

Case contributed by Dr Nafisa Shakir Batta

Presentation

Pain and feeling of give way after cycling injury 10 days back

Patient Data

Age: 18 years
Gender: Female

Ultrasound shows abnormally thickened and hypoechoic MCL, with minimal free fluid in the lateral patellar recess, and thin rim of free fluid along the pes anserine bursa. Comparison images are seen showing the normal MCL configuration of the contralateral knee.

The MCL is thickened with focal discontinuity at mid fibers and surrounding free fluid which is in keeping with MCL grade 3 injury or full thickness tear. There is edema at medial patellofemoral ligament (MPFL), medial patellar retinaculum and distal fibers of vastus medialis obliquus.

Focal full thickness Vshaped cartilage defect of 3.5mm is noted at medial facet of patella with bony contusion at lateral femoral condyle suggesting impaction injury due to repeated lateral patellar subluxation.

Case Discussion

MRI knee reveals  a fullthickness MCL tear, lateral patellar instability and focal chondral injury at patella.

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Case Information

rID: 29282
Case created: 14th May 2014
Last edited: 16th Aug 2016
Inclusion in quiz mode: Included

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