Question 1610

{"accessible":true,"alternatives":[{"id":8017,"text":"deep sulcus sign"},{"id":8018,"text":"medial meniscal tear"},{"id":8019,"text":"lateral meniscal tear"},{"id":8020,"text":"ramp lesion"},{"id":8021,"text":"Segond fracture"}],"archived":false,"correctAlternativeId":8019,"explanation":"\u003cp\u003eThe injury pattern shown in the image is an\u0026nbsp;\u003ca href=\"/articles/anterior-cruciate-ligament-tear\"\u003eanterior cruciate ligament tear\u003c/a\u003e\u0026nbsp;and a\u0026nbsp;\u003ca href=\"/articles/medial-collateral-ligament-injury-grading\"\u003epartial tear of the medial collateral ligament\u003c/a\u003e\u0026nbsp;involving the deep portion, typically seen as a result of valgus stress.\u003c/p\u003e\u003cp\u003eA lateral\u0026nbsp;\u003ca href=\"/articles/meniscal-tear\"\u003emeniscal tear\u003c/a\u003e\u0026nbsp;can occur in this type of injury and is more common than a medial meniscal tear in the acute setting and thus is the right answer. There was also a small lateral menical tear athroscopically proven in this case.\u003c/p\u003e\u003cp\u003eA\u0026nbsp;\u003ca href=\"/articles/segond-fracture\"\u003esegond fracture\u003c/a\u003e\u0026nbsp;is a avulsion fracture involving the lateral aspect of the knee also often seen in\u0026nbsp;\u003ca href=\"/articles/anterior-cruciate-ligament-tear\"\u003eACL tears\u003c/a\u003e, but occurs as a result of varus stress.\u003c/p\u003e\u003cp\u003eA medial\u0026nbsp;\u003ca href=\"/articles/meniscal-tear\"\u003emeniscal tear\u003c/a\u003e\u0026nbsp;is another type of injury in the same setting but occurs less often and is also known as\u0026nbsp;\u003ca href=\"/articles/o-donoghue-unhappy-triad\"\u003eO’Donoghue\u0026nbsp;unhappy triad\u003c/a\u003e. They are also more common in the setting of chronic ACL insufficiency.\u003c/p\u003e\u003cp\u003eA\u0026nbsp;\u003ca href=\"/articles/ramp-lesion-meniscus\"\u003eramp lesion\u003c/a\u003e\u0026nbsp;is a tear of the meniscocapsular/meniscotibial liagment in the posteromedial corner of the knee occuring in ACL deficient knees.\u003c/p\u003e\u003cp\u003e\u003ca href=\"/articles/deep-sulcus-sign-chest\"\u003eDeep sulcus sign\u003c/a\u003e: 1\u003csup\u003est\u003c/sup\u003e\u0026nbsp;a radiological sign is not an injury, 2\u003csup\u003end\u003c/sup\u003e\u0026nbsp;deep sulcus sign is sign for pneumothorax and not seen here. A sign often seen in ACL disruption is the\u0026nbsp;\u003ca href=\"/articles/lateral-femoral-notch-sign-knee\"\u003e(deep) lateral femoral notch sign\u003c/a\u003e\u0026nbsp;sometimes also called\u0026nbsp;\u003ca href=\"/articles/lateral-femoral-notch-sign-knee\"\u003edeep lateral sulcus sign\u003c/a\u003e,\u0026nbsp;which represents an impaction injury from a collision of the lateral femoral condyle at a point near the conylopatellar sulcus with the posterior plateau.\u003c/p\u003e","id":1610,"imageUrl":"https://prod-images-static.radiopaedia.org/multiple_choice_questions/142/ACLAndMCL_injury_big_gallery.jpeg","imageAttribution":{"kind":"case","rID":74862},"imageAttributionCaseInfo":{"title":"Multi-ligament injury of the knee","contributor_name":"Joachim Feger","contributor_param":"jfeger","case_rid":74862,"case_param":"multi-ligament-injury-of-the-knee-2"},"firstQuestionPath":"/questions/1610","nextQuestionPath":null,"relatedArticles":[{"id":32943,"title":"Meniscal tear","link":"/articles/meniscal-tear?lang=us"},{"id":21374,"title":"Lateral femoral notch sign (knee)","link":"/articles/lateral-femoral-notch-sign-knee?lang=us"},{"id":10926,"title":"Medial collateral ligament injury grading","link":"/articles/medial-collateral-ligament-injury-grading?lang=us"},{"id":12490,"title":"Anterior cruciate ligament tear","link":"/articles/anterior-cruciate-ligament-tear?lang=us"},{"id":1749,"title":"O'Donoghue unhappy triad","link":"/articles/odonoghue-unhappy-triad-1?lang=us"},{"id":13294,"title":"Deep sulcus sign (chest)","link":"/articles/deep-sulcus-sign-chest?lang=us"}],"alsoUsedIn":[],"stem":"\u003cp\u003eA 15-year-old girl suffered a knee twisting injury accompanied by a popping sensation during a volleyball game.\u003c/p\u003e\u003cp\u003eIn the \u003cstrong\u003eacute\u003c/strong\u003e setting, which of the following associated injuries is most likely to accompany the patient's pattern of injury shown on the images?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/1610"}],"attemptsPercentages":[{"alternativeId":"8018","percentage":21},{"alternativeId":"8017","percentage":26},{"alternativeId":"8021","percentage":20},{"alternativeId":"8019","percentage":23},{"alternativeId":"8020","percentage":10}],"promptToLogin":false,"questionManager":false,"articleId":"ramp-lesion-meniscus"}