Posterior cruciate ligament tear

Case contributed by Dr Michał Czerny

Presentation

Popliteal fossa and infrapatellar region pain after suffering trauma during football (soccer) game. No complaints of instability.

Patient Data

Age: 20 years
Gender: Male
MRI

Knee MRI

There is markedly increased signal (especially on fluid sensitive sequences) along the PCL with evident disruption of fibers continuity. 

Intraarticular effusion, mostly in the suprapatellar recess. 

Lateral patellar incongruence, partly due to articular effusion. Patellar cartilage centrally has very discrete stripes of increased signal (AX PDFS). Very discrete edema/fluid layer along patellar attachment of MPFL. 

Small disruption/irregularity of anterior horn free edge of lateral meniscus oriented radially. 

Small fluid/edematous leakage into Hoffa fat pad. 

Case Discussion

The salient findings are consistent with a high-grade partial-thickness posterior cruciate ligament tear. Interestingly the patient didn't complain of joint instability although he did suffer from popliteal pain. 

Additionally, there is a serious suspicion for initial patellar chondromalacia and less likely mild injury of patellar attachment of MPFL  (to be correlated with any history of patellar instability / transient displacement; no such information was available at the time of reporting). 

Anterior horn of lateral meniscus seemed to have a very small radial tear - to be verified in follow up exam or arthroscopy. Signs of fluid/edema streak in Hoffa fat pad are indicating a small infrapatellar synovial plica tear. 

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Case information

rID: 58978
Published: 18th Mar 2018
Last edited: 19th Mar 2018
Inclusion in quiz mode: Included

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