Presentation
Pain and feeling of give way after cycling injury 10 days back
Patient Data
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 3.5 mm 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 full-thickness MCL tear, lateral patellar instability, and focal chondral injury at the patella.