sharing sensitive information, make sure youre on a federal Snearly WN, Kaplan PA, Dussault RG. Bone marrow contusions are frequently identified at magnetic . LXC designed the study and was responsible for the paper. Orthop J Sports Med 2014;2:2325967113519741. Kapelov SR, Teresi LM, Bradley WG, Bucciarelli NR, Murakami DM, Mullin WJ, et al. Magnetic resonance imaging of bone bruising in the acutely injured kneeshort-term outcome. The positive rate of KC in the experimental group (183/500) was markedly higher than that in the control group (3/500) (P<0.05). 1989 Jun;171(3):761-6 Medial and lateral meniscal tears usually involving the . Orthop J Sports Med. There has been limited investigation to subdividing the bone contusion model in the medial and lateral directions of the tibial plateau and the . eCollection 2020 Apr. Google Scholar, Bernard M, Pappas E, Georgoulis A, Haschemi A, Scheffler S, Becker R (2020) Risk of overconstraining femorotibial rotation after anatomical ACL reconstruction using bone patella tendon bone autograft. The spectrum of damage includes stretching, partial tearing, and complete rupture [4]. They can be used to diagnose ACL injuries. A prospective study of the association between bone contusion and intra-articular injuries associated with acute anterior cruciate ligament tear. The double sulcus sign is a radiographic marker that confers a high probability of ACL injury. Orthop Surg. CAS endobj Acta Orthop Traumatol Turc. Meyer EG, Baumer TG, Haut RC. uuid:a4a67e1a-1dd1-11b2-0a00-880000000000 Case study, Radiopaedia.org (Accessed on 02 May 2023) https://doi.org/10.53347/rID-83381. CAS 2003;37:1379. Radiographics. PMC <>stream Learn more about Institutional subscriptions. Hayes CW, Brigido MK, Jamadar DA, Propeck Tim. Mandalia V, Fogg AJB, Chari R, Murray J, Beale A, Henson JHL. Thank Professor Zhuozhao Zheng and my girlfriend Danyu Chen for their advice and help on this study. They found that all the lesions in one patient do not heal at exactly the same speed. Informed consent was obtained from the patients in English or regional language. -. MRIs, plain radiographs and clinical details of these patients were reviewed. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Magnetic Resonance Imaging of Bone Marrow: A Review Part II. Many patients coming with complain of pain following injury without radiographic evidence of fracture, MRI yields presence of extensive injury marrow which is characterised by marrow oedema and haemorrhage termed as bone bruise. The secondary aims were to study bone marrow oedema patterns in setting of acute knee trauma, to associate the type of knee injury (from clinical history) with bone marrow oedema pattern, to determine the most common oedema pattern and to assess the most common type/mode of injury. Our imaging services center is on the 1st floor of the hospital, directly behind our main reception area. Bone bruising of the knee. endobj The magnitude of the force is a major determinant of the imaging findings. Accessibility Although bone marrow oedema is nonspecific and has a similar appearance in inflammatory and neoplastic disorders, a traumatic cause is usually obvious on the basis of the clinical history, location of bone marrow oedema and the presence of other trauma related findings. 2007;189:55662. Patient demographics, the clinical presentation, and the role of trauma are critical for . Objective: To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint. 2000;20:S13551. Asai K, Nakase J, Oshima T, Shimozaki K, Yoshimizu R, Tsuchiya H (2020) Partial resection of the infrapatellar fat pad during anterior cruciate ligament reconstruction has no effect on clinical outcomes including anterior knee pain. Pivot shift injury in different location and its correlation with sports related injury and other type/mode of injury. An axial acquisition through the patella femoral joint was used as the initial localizer for subsequent coronal and saggital images. %PDF-1.4 % In patients with bone marrow contusion, 14 were women (10.1%) and 124 were men (89.9%). Pivot shift pattern is most common contusion pattern and the most common type/mode of sports related injury. It is a rare (6.3% in this series) but significant injury, often associated with ligamentous or menisceal tears. Horizontal Rafting Plate for Treatment of the Tibial Plateau Fracture. Boks et al., conducted a study of the natural course of bone bruises in posttraumatic knees and to describe possible determinants of this course and concluded that Median healing time of bone bruises is 42.1 weeks [5]. Correlation between contusion pattern in clip injury and type/mode of injury. 2012;2 (5): 398-402. N Z Med J. In present study transient dislocation of patella pattern is noted in 3 cases (2.2%). sharing sensitive information, make sure youre on a federal Contusions of both surfaces of the joint are known as kissing contusions. Compression and tension are two basic loads that commonly act on the knee [4]. Clipboard, Search History, and several other advanced features are temporarily unavailable. In these 16 cases, contusion in medial compartment was noted in 2 cases (12.5%) [13]. These contusions are generally found by magnetic resonance imaging and most cases are associated with ligamentous or menisceal injuries.[1]. MRI follow-up of posttraumatic bone bruises of the knee in general practice. XZ contributed to part of the statistics of the article. Notch depth equal to 0.72mm can be basically considered as the optimal cut-off point for LFNS in statistics. 10 0 obj Semin Ultrasound CT MR. 1994 Oct;15(5):396-409. doi: 10.1016/s0887-2171(05)80006-x. Background: Eur J Radiol. 2007;41 Suppl 2:98-104. Common entities include acute traumatic osteochondral injuries, subchondral insufficiency fracture, so-called spontaneous osteonecrosis of the knee, avascular necrosis, osteochondritis dissecans, and localized osteochondral abnormalities in osteoarthritis. 5 Resident, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. Rodriguez W, Vinson EN, Helms AC, Toth PA. MRI appearance of posterior cruciate ligament tears. Google Scholar. AJR Am J Roentgenol. The https:// ensures that you are connecting to the In impaction, the compressive force directly strikes cortical bone and is dissipated into trabecular bone [4]. Part of Springer Nature. Our study only involves the image information of patients. 2014 . Application of biomechanical approach in MR interpretation helps in effortless assessment of osseous contusion and ligament rupture and mark delicate but significant abnormalities. By analysing bone marrow contusion pattern, type/mode can be determined in most of the cases. MRI Introduction Anterior cruciate ligament (ACL) injuries are among the most common sports injuries. Other structures are injured less frequently and have weaker associations with bone bruise distribution. Green DW, Hidalgo Perea S, Kelly AM, Potter HG. This site needs JavaScript to work properly. 1 0 obj Radiographics. 1. [Table/Fig-10,,1111 and and12]12] show the aetiologies and location for pivot shift injury, Type /Mode of injury among dashboard injury pattern (8 cases) were - Impact from dashboard in 4 cases, fall from bike (2 cases), running downstairs (1 case) and fall while paying cricket (1 case). These findings are comparable to Arndt et al., who conducted a study in MR diagnosis of contusion of knee in < 6 weeks and described bone marrow contusion in 23 cases out of 51 cases (45.1%). Patients were scanned using 1.5 Tesla Seimens Avanto (Tim + Dot) with Tx/Rx 15 channel knee coil # Tim. The KIS Imaging program was designed to direct patient care, through a concierge service, in which employees and employers can realize up to an 80% savings on all major imaging. While the knee is in a state of flexion, twisting motion of the knee can lead to transient dislocation of knee. The coronal lateral collateral ligament sign in the anterior cruciate ligament-injured knees was observed regardless of the knee laxity based on the quantitative measurements. SuzanneWitjes, Tammo HPels Rijcken, Cor Pvan der Hart. Winters K, Tregnonning R. Reliability of magnetic resonance imaging of the traumatic knee as determined by arthroscopy. Bone Marrow Edema Injury Patterns in the Pediatric Knee: An MRI Study. Knee kinematics during noncontact anterior cruciate ligament injury as determined from bone bruise location. Article 1996;198:2058. We describe the clinical and radiographic features of 11 athletes found to have femoral head lesions similar in MR imaging appearance to osteochondral lesions in other locations, such as the knee and ankle. Terzidis et al., 20 conducted a study on acute knee injuries in 255 athletes with acutely injured knees, 219 MRIs were done within the first month after the injury and 36 within two to four months [13]. Acute findings of a joint effusion and posterior tibial plateau contusion are present. According to study conducted by Terzidis et al., Kissing contusion in acute knee injury is noted in 16 cases out of 225 (7.1%). The primary aim of the study was to identify imaging pattern in bone marrow oedema and to correlate the pattern of bone marrow oedema retrospectively with type of knee injury from clinical history. 2015;23(8):22508. <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB]/XObject<>>>/Rotate 0/TrimBox[57.25999 58.11 666.34 848.69299]/Type/Page>> By directing imaging . The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). endobj Google Scholar, Department of Orthopaedic Surgery, Chelsea and Westminster Hospital, London, UK, Department of Radiology, Chelsea and Westminster Hospital, London, UK, Department of Orthopaedic Surgery, Homerton University Hospital, London, UK, You can also search for this author in HHS Vulnerability Disclosure, Help 6 Resident, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. Arch Orthop Trauma Surg 140(12):20132020, Article Popular works include The appearance of kissing contusion in the acutely injured knee in the athletes, Role of Magnetic Resonance Imaging in Study of the Patellofemoral Joint Morphological Abnormalities Predisposing to Patellar Instability and more. PubMed The 32 bone contusions (16 kissing contusions) were located as follows: lateral femoral condyle (n = 14; 8 type I, 6 type II); lateral tibial condyle (n = 9; 3 type I, 1 type II, 5 type III); medial tibial condyle (n = 7; 2 type I, 5 type III); medial femoral condyle (n = 2; both type I). In this case, patient has had a hyperextension external rotation injury of the knee as evidenced by the kissing bone marrow contusions in the anterior aspect of the lateral femoral condyle (LFC) and the lateral tibial plateau. Follow-up of occult bone lesions detected at MR imaging: systematic review. 5 out of 8 patients with a 'double sulcus' on the lateral radiograph had ACL injury. endobj Ready to get started? Bone contusion and associated meniscal and medial collateral ligament injury in patients with anterior cruciate ligament rupture. In tensile load, on the other hand, bones pull apart leading to distraction across the joint and traction on stabilizing structures. 2021 May;13(3):966-978. doi: 10.1111/os.12997. This case demonstrates a hyperextension knee injury consisting of. 1996;330:13342. On MR images, trabecular contusion has the appearance of bone marrow oedema. Epub 2013 Jun 6. MeSH Grade II ACL tears represent intraligamentous injury and an increase in ligament length. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). PubMed Bone marrow oedema on T2 weighted magnetic resonance (MR) images is recognized as an ill-defined hyperintensity in the bone marrow where standard radiographs showed nonspecific osteopenia or normal findings [3]. The lateral femoral notch sign (LFNS) and the kissing contusion (KC) are two indirect signs of anterior cruciate ligament (ACL) injuries. Archives of Orthopaedic and Trauma Surgery, https://doi.org/10.1007/s00402-022-04366-9. Type I lesions are most common on the lateral femoral condyle and type III on the lateral tibial condyle. Contusion is seen in the anterior aspect of the distal femur and proximal tibia or located in medial femoral and tibial condyle (valgus force applied). For KC, the corresponding values were 36.6% and 99.4%, respectively. Transient patellar dislocation is a common sports-related injury in young adults. see full revision history and disclosures, posterior soft tissue injuries involving the knee joint capsule, fibular attachment of soleus and distal semimembranosus tendon. Inclusion criteria were patients with recent knee injuries (<6weeks) and normal plain radiograph with no signs of pathology. LF directed the writing of the article. 2023 Feb;143(2):927-934. doi: 10.1007/s00402-022-04366-9. Diagnostic value of the lateral femoral notch sign and kissing contusion in patients with anterior cruciate ligament injuries: a casecontrol study. An official website of the United States government. Table showing Type/Mode of injury in pivot shift injury. Would you like email updates of new search results? Biomechanical and anatomical assessment after knee hyperextension injury. Shea KG, Archibald-Seiffer N, Murdock E, Grimm NL, Jacobs JC Jr, Willick S, Van Houten H. Knee injuries in downhill skiers: a 6-year survey study. Correspondence to 2023 Feb;19(1):107-112. doi: 10.1177/15563316221092320. 1996 Jan;198(1):205-8 Type/Mode of injury in these cases are: impact during car accident in 4 cases, fall on flexed knee while playing cricket in 1 case, while getting downstairs in 1 case and fall from bike in flexed knee in 2 cases. MRIs, plain radiographs and clinical details of these patients were reviewed. Right knee injury was noted in 87 cases (63%) and left knee in 51 cases (37%). Bone marrow contusion was noted in lateral femoral condyle in 15 cases (38.5%) and involving lateral and medial femoral condyle in 24 cases (61.5%). As a library, NLM provides access to scientific literature. KIS Imaging is the nations largest direct contracting imaging network with over 2,600 providers covering all major imaging needs: MRI, CT and PET. Anterior tibial plateau oedema and rupture of the posterior capsule predicted cruciate ligament injury [OR=10.5 (p=0.02) and 24.0 (p=0.001) respectively]. This is a preview of subscription content, access via your institution. Language links are at the top of the page across from the title. In one of these patients, the lesion was still seen at 1-month follow-up, and in the other patient, complete resolution occurred after 10 months. bone contusion) can give clues for the mechanism and associated injuries. {"url":"/signup-modal-props.json?lang=us"}, Knipe H, Yap J, Al Kabbani A, et al. Knee Surg Sports Traumatol Arthrosc. According to study conducted by Terzidis et al., Kissing contusion in acute knee injury is noted in 16 cases out of 225 (7.1%). Bone bruise patterns in knee injuries: where are they found? Federal government websites often end in .gov or .mil. Davies NH, Niall D, King LJ, Lavelle J, Healy JC. Inpatient imaging services are available 24/7. Skeletal Radiol 47, 173179 (2018). In this study, the time gap between injury and doing MRI was not considered. CAS The double sulcus sign is a radiographic marker that confers a high probability of ACL injury. Unable to load your collection due to an error, Unable to load your delegates due to an error. Notch syndrome refers to the enlarged and deepened lateral femoral condyle. HW contributed to some imaging data and surgery. <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/TrimBox[57.25999 58.11 666.34 848.69299]/Type/Page>> endobj Knee Surg Sports Traumatol Arthrosc 23(8):22502258, Hoffelner T, Pichler I, Moroder P et al (2015) Segmentation of the lateral femoral notch sign with MRI using a new measurement technique. PDFS Saggital: Bone marrow oedema at Medial femoral and Medial tibial condyle in Hyperextension injury. Injury in PCL is seen in all the cases. Please enable it to take advantage of the complete set of features! Type / Mode of injury in Clip injury pattern. The authors have no relevant financial or non-financial interests to disclose. The site is secure. Arthroscopy. of knee injury in pediatric patients. The pattern of bone bruise in knee injuries (a.k.a. 2000;24:37180. 2016. https://doi.org/10.1016/j.arthro.2016.03.015. <> National Library of Medicine A 30-year-old woman with acute knee injury. Patient was placed in supine position with knee externally rotated 10-20 degree 21. PubMed Central Home; Service. Kissing contusion is a significant injury often associated with ligamentous or menisceal injuries. The depth of LFNS and the presence of KC were determined on MRI findings. Mair SD, Schlegel TF, Gill TJ, Hawkins RJ, Steadman JR. The https:// ensures that you are connecting to the 1020 AJR:196, May 2011 Pai and Strouse ulation [2, 3]. 2013 Aug;41(8):1801-7. doi: 10.1177/0363546513490649. 2023-05-01T23:01:26-07:00 2002;10:96101. Knee Surg Sports Traumatol Arthrosc 27(2):659664, Miller LS, Yu JS (2010) Radiographic indicators of acute ligament injuries of the knee: a mechanistic approach. Radiology 182(1):221224, Niitsu M, Kuramochi M, Anno I, Itai Y (1995) Secondary signs of anterior cruciate ligament tear at MR imaging. Pattern of marrow oedema as per classification. endobj Imaging was done using FOV: 160 mm, slice thickness of 3 mm on Saggital images; FOV: 170 mm, slice thickness of 3 mm on coronal images; FOV: 170 mm, slice thickness on 3.5 mm and axial images with interslice gap of 1.5 mm. Ali, A.M., Pillai, J.K., Gulati, V. et al. Bone marrow oedema is usually most prominent in the lateral femoral condyle secondary to the direct blow, whereas a second smaller area of oedema in the medial femoral condyle secondary to avulsive stress to the MCL. FOIA Meniscal injury was unrelated to the extent or pattern of bone bruising. and transmitted securely. In total 200 cases, bone marrow contusion was noted in 138 cases (69%) and absent contusion in 62 cases (31%). Bookshelf Among 46 cases, football was most common sports leading to injury followed by Kabaddi. Department of Radiology, Wilford Hall Medical Center, 759th MDTS/MTRD, 2200 Bergquist Dr, Ste 1, Lackland AFB, TX 78236-5300, USA. Bone marrow oedema may also be rarely seen at adductor tubercle of the medial femoral condyle due to avulsion injury of the medial patellofemoral ligament. MR imaging performed in two patients with kissing contusions showed persistence of the tibial lesions. Archives of Orthopaedic and Trauma Surgery In six cases (4.3%) no pattern of bone marrow contusion could be explained and was categorized as unclassified pattern.
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