Posterior cruciate ligament avulsion fracture

Case contributed by Ahmed Abdrabou


Severe knee pain during football game after doing vigorous exercise.

Patient Data

Age: 25 years
Gender: Male

The patient encountered a hyperextension injury of the knee with the resultant constellation of findings:

  • avulsion fracture of the PCL with bony fragment from its tibial attachment
  • horizontal tear of the lateral meniscus with large parameniscal cyst
  • abnormal signal within the belly of popliteus muscle likely hematoma with intact popliteal tendon
  • bone bruise at the posterolateral corner of the tibial plateau

Lateral collateral ligament, biceps femoris tendon, popliteo-fibular ligament, arcuate ligament and iliotibial tracts are intact.

Annotated image

The white arrows point to the parameniscal cyst.

The red arrow refers to the torn posterior root ligament of lateral meniscus.

Dashed blue arrows refer to the popliteus muscle which is enlarged and shows abnormal signal

Case Discussion

Hyperextension of the knee can induce overstretch of the PCL with avulsion of its bony attachment at the tibia as in this case. 

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