Posterior cruciate ligament avulsion fracture - type III

Case contributed by Ali Abougazia

Presentation

Severe trauma to the knee during a football match.

Patient Data

Age: 16 years
Gender: Male

Grade III avulsion fracture of the posterior cruciate ligament, with displaced avulsed tibial bony attachment. 

Lipohemarthrosis is noted with hematocrit effect.

The popliteus muscle belly shows heterogeneous high T2 signal with an intact tendon. Marrow edema at the popliteus tendon origin from the lateral aspect of the lateral femoral condyle.

Intact anterior cruciate ligament.

Grade I sprain of lateral collateral ligament of the knee.

Case Discussion

The findings are compatible with type III PCL avulsion with lipohemarthrosis and popliteus muscle contusion.

Learning point:  In cases of trauma, always look for muscular injuries, always try to obtain an additional x-ray to detect subtle fractures, and always exclude lipohemarthrosis which indicates a missed intra-articular fracture.

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