Partial thickness MCL tear (grade 2)

Case contributed by Dai Roberts
Diagnosis almost certain

Presentation

Awkard tackle playing football, medial knee pain. ? meniscal tear

Patient Data

Age: 35 years
Gender: Male

Edema is both superficial and deep to the MCL, with partial disruption proximally and traction edema in the medial femoral condyle. Normal ACL, PCL, and lateral collaterals.  Intersubstance intermediate signal is within the posterior third of the medial meniscus without contacting an articular surface.  Partial-thickness loss and fissuring of the medial patella facet articular cartilage.  

Impression: Grade 2, high-grade partial-thickness MCL tear.  No meniscal tear.

Case Discussion

Medial collateral ligaments (MCL) tears can be graded into 1, 2, and 3, with 3 being indicating complete disruption.  

Intermensical fluid signal must contact an articular surface to be diagnostic for an MRI tear.  Classically this was stated on 2 or more consecutive slices, however, with smaller slice thickness MRI, meniscal tear morphology is favored by many to make a diagnosis.  

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