While the knee is in a state of flexion, twisting motion of the knee can lead to transient dislocation of knee. Bratisl Lek Listy 113(9):539543, Svoboda SJ (2014) ACL injury and posttraumatic osteoarthritis. Correlation between type or mode of injury and patterns of bone marrow oedema was determined using p-value and chi-square method. Following informed consent, complete history from the patient and relative (attendant) about injury was recorded. <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB]/XObject<>>>/Rotate 0/TrimBox[57.25999 58.11 666.34 848.69299]/Type/Page>> <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/TrimBox[57.25999 58.11 666.34 848.69299]/Type/Page>> . MeSH A cross-sectional study was done on all patients referred to Krishna Hospital, Karad for MRI knee with history of recent (< 6 weeks) knee injury. 2012;2 (5): 398-402. Bone bruise patterns in knee injuries: where are they found? Bethesda, MD 20894, Web Policies Google Scholar. If the knee is exposed to forces beyond its physiologic range, risk of injury to bone or soft tissue structures increases. Arthroscopy. Before Radiographics : a Review Publication of the Radiological Society of North America, Inc , 01 Oct 2000, 20 Spec No: S135-51. PubMed Terzidis IP, Christodoulou AG, Ploumis AL, Metsovitis SR, Koimtzis M, Givissis P. The appearance of kissing contusion in the acutely injured knee in the athletes. 2000;28:6637. - 103.57.222.214. 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 authors have no relevant financial or non-financial interests to disclose. 2016;10(4):TC0611. Am J Sports Med. HSS J. Table showing Type/Mode of injury in pivot shift injury. "Kissing contusion" refers to a bone contusion on both side of the knee joint. Journal of Clinical and Diagnostic Research : JCDR, Lateral tibial plateau and medial femoral condyle, Medial femoral condyle, Metadiaphysis femur, Medial femoral condyle, proximal tibia and head. 2023-05-01T23:01:26-07:00 Perin B, Nardacchione R, Bonaga S, Angelini F, Girotto A, Giovagnoni A, et al. Article The patients age ranged from 17-65 years and majority of patients were in 21-30years age group. Injury in PCL is seen in all the cases. Xie D, Murray J, Lartey R, Gaj S, Kim J, Li M, Eck BL, Winalski CS, Altahawi F, Jones MH, Obuchowski NA, Huston LJ, Harkins KD, Friel HT, Damon BM, Knopp MV, Kaeding CC, Spindler KP, Li X. Osteoarthritis Cartilage. government site. Patient was placed in supine position with knee externally rotated 10-20 degree 21. The https:// ensures that you are connecting to the Knee Surg Sports Traumatol Arthrosc. Objective: To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint. 8600 Rockville Pike 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. Case Discussion. Br J Sports Med 38(5):592596, Article Am J Sports Med. There were 2 cases with hyperextension injury while playing football and 2 patients attained the injury after being hit by car. Knee Surg Sports Traumatol Arthrosc. 21033-6-01). On MRI these injuries appears as ill defined, subchondral, reticulated or stellate region of low signal intensity on T1W and high signal intensity on T2W images [6]. 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]. Characteristic magnetic resonance imaging (MRI) findings often lead to the diagnosis. -, Arthroscopy. Park HJ, Lee SY, Chung EC, Rho MH, Ahn JH, Kim M, et al. Vojnosanit Pregl. Objective: PubMed 5 Resident, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. The site is secure. Pattern of marrow oedema as per classification. A cross-section study was done on all patients reffered to Krishna Hospital, Karad for MRI knee with history of recent (< 6 weeks) knee injury. Presence of contusion may also effect management of knee injuries often requiring prolonged rest even in absence of surgical correctible lesion and establishing diagnosis of bone marrow contusion may obviate further costly work up like arthroscopy. In this study hyperextension injury noted in 4 cases in 138 cases (2.9%). The .gov means its official. A 14-year-old male football player with chronic anterior knee pain who experienced acute knee pain after jumping and landing awkwardly. Check for errors and try again. 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%). Zeiss J, Paley K, Murray K, Saddemi SR. Correspondence to Prognosis is particularly influenced by the presence of osteoarthritis. PubMed 33 0 obj The double sulcus sign is a radiographic marker that confers a high probability of ACL injury. The site is secure. Herbst E, Hoser C, Tecklenburg K, Filipovic M, Dallapozza C, Herbort M, et al. Background: The location and severity of tibiofemoral bone contusions in magnetic resonance imaging scans in patients with acute non-contact anterior cruciate ligament injuries can reflect the primary mechanisms of anterior cruciate ligament injuries. . 2023 Feb;143(2):927-934. doi: 10.1007/s00402-022-04366-9. 2021 Nov 11;6(4):e21.00069. In suspected ACL injury, bone marrow contusion may not be necessarily present. Book an Appointment. Tax calculation will be finalised during checkout. 2022 Dec;30(12):1647-1657. doi: 10.1016/j.joca.2022.08.006. The diagnostic outcome of LFNS was not in agreement with that of KC, as there was a poor coincidence according to the Kappa coefficient (Kappa=0.155<0.4, P=0.035). Pivot shift injury depending on location and type/mode of injury. *Other cause include fall while getting down from bus (1 case), fall while jumping (1 case), fall while getting downstairs. AJR Am J Roentgenol. Br J Sports Med 42(6):394412, Saxena A, Ray B, Rajagopal K, DSouza A, Pyrtuh S (2012) Morphometry and magnetic resonance imaging of anterior cruciate ligament and measurement of secondary signs of anterior cruciate ligament tear. . Please enable it to take advantage of the complete set of features! MRI of the Pediatric Knee Pediatric Imaging Review. HWnWhl2 p$%SgdR`Qvs4a^q~z]&O_F?`7%|8W.Zyxc\4x{gJSp>)nO|-6bhLCntyFTVe7WwtR?fs;fLh;>|*E{mIvqGUlT! 2000;20:S13551. Provided by the Springer Nature SharedIt content-sharing initiative, Over 10 million scientific documents at your fingertips, Not logged in The presence of a double sulcus showed significant association with anteromedial kissing contusions (OR = 7.8, p = 0.03). Semin Ultrasound CT MR. 1994 Oct;15(5):396-409. doi: 10.1016/s0887-2171(05)80006-x. Google Scholar. 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). On MR images, trabecular contusion has the appearance of bone marrow oedema. Kung JW, Yablon CM, Eisenberg RL. Chi-square = 1.926, p =0.3817 i.e. Furthermore, it is anterior tibial oedema rather than the presence of kissing lesions than predicts cruciate ligament injury (OR = 10.5, p = 0.02). Other associated injury in ACL (87.5%), Medial meniscus (50 %) and lateral meniscus (75%). Reflecting presence of increased free water oedema, appears hyperintense on inversion recovery and fat suppressed images and shows increase diffusivity on Diffusion weighted images [10]. On analysing the bone marrow contusion pattern, type/mode can be determined in most of cases. from publication: The appearance of kissing contusion in the acutely injured knee in the athletes | Bone contusions are often identified at magnetic resonance imaging (MRI) in the acutely. FOIA 2002;10:96101. Davies NH, Niall D, King LJ, Lavelle J, Healy JC. Epub 2022 Apr 12. 1989 Mar;170(3 Pt 1):823-9 Deangelis JP, Spindler KP. Bone bruise represents as acute, occult microfractures of subchondral trabecular bone with subsequent haemorrhage, oedema and hyperemia. Calvo-Gurry M, Hurley ET, Withers D, Vioreanu M, Moran R. Knee Surg Sports Traumatol Arthrosc. 2016. https://doi.org/10.1016/j.arthro.2016.03.015. Unable to process the form. This is a preview of subscription content, access via your institution. <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/TrimBox[57.25999 58.11 666.34 848.69299]/Type/Page>> Hyperextension of the knee can result when direct force is applied to the anterior tibia while the foot is planted or from an indirect force, such as a forceful kicking. Patient demographics, the clinical presentation, and the role of trauma are critical for . Boks SS, Vroegindeweij D, Koes BW, Bernsen R, Hunink MGM, Zeinstra SM. Google Scholar, Pao DG (2001) The lateral femoral notch sign. 2 Resident, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. 1996;330:13342. Archives of Orthopaedic and Trauma Surgery, https://doi.org/10.1007/s00402-022-04366-9. 31 0 obj Extensive posterior capsular edema in keeping with a hyperextension injury. Bethesda, MD 20894, Web Policies The values of notch depth in patients who had ACL rupture concomitant lateral MT injuries and medial collateral ligament (MCL) injuries were 1.120.64 and 1.230.74mm, respectively, which were significantly higher than those in patients with only ACL injury (0.890.49mm) (P<0.05). 2021 Jun;13(4):1343-1350. doi: 10.1111/os.12967. A prospective study of the association between bone contusion and intra-articular injuries associated with acute anterior cruciate ligament tear. 1998 Jun;69(3):291-4 2 cases (50%) are hyperextension injury with kissing contusion at anterior aspect of proximal tibia and distal femur caused due to hit by car in RTA. The purpose of this review is to . PubMed knees against dashboard in motor vehicle collision, or fall onto flexed knee), contusion pattern:anterior tibia +/- posterior patella, contusion pattern: lateral femoral condyle and lateral tibial plateau +/- medial femoral condyle from medial collateral ligament (MCL) avulsive stress, direct force to anterior tibia with foot planted, contusion pattern: "kissing contusions" of anterior tibial plateau and anterior femoral condyle, contusion pattern: anterolateral lateral femoral condyle and inferomedial patella, associated with medial patellar retinaculum +/-. Horizontal Rafting Plate for Treatment of the Tibial Plateau Fracture. In this study, patients with history of knee injury <6 weeks were considered as recent knee injuries. PubMedGoogle Scholar. Accessibility Frequent abnormalities found on MR imaging include labral tear or injury, stress fracture, and avascular necrosis . Sanders TG, Medynski MA, Feller JF, Lawhorn KW. Adult patients with ACL tears have greater tibial internal rotation in MRI compared to adolescent patients. 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. At the time the case was submitted for publication Henry Knipe had no recorded disclosures. 2015;43(10):251521. Article Bone contusion and associated meniscal and medial collateral ligament injury in patients with anterior cruciate ligament rupture. [1] References [ edit] ^ Terzidis, I. P. (October 2004). 2010 Dec;38(12):2502-8. doi: 10.1177/0363546510376232. Out of 200 patients, 32 were women (16%) and 168 men (84%). volume143,pages 927934 (2023)Cite this article. 5 out of 8 patients with a double sulcus on the lateral radiograph had ACL injury. Most common type/mode of injury in clip injury pattern in fall from two wheeler in 26 cases (66.7%). Reference article, Radiopaedia.org (Accessed on 02 May 2023) https://doi.org/10.53347/rID-43268, Case 3: pivot-shift injury with ACL and meniscal tears, Case 4: pivot-shift injury with impacted tibial plateau fracture, see full revision history and disclosures, doi:10.1148/radiographics.20.suppl_1.g00oc19s135, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, Ahlback classification system in assessing osteoarthritis of the knee joint, Kellgren and Lawrence system for classification of osteoarthritis, anterior cruciate ligament mucoid degeneration, MRI grading system for meniscal signal intensity, Pattern of bone contusion in knee injuries, valgus stress to flexed and externally rotated knee, contusion pattern:posterolateral tibial plateau and mid part of lateral femoral condyle, anterior force to tibia in a flexed knee (e.g. 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. Before 2023 Springer Nature Switzerland AG. 13 0 obj Bone bruising; Knee hyperextension; MRI. The LFNS and KC have strong clinical significance in the diagnosis of ACL injuries. Arch Orthop Trauma Surg 140(7):923931, Renstrom P, Ljungqvist A, Arendt E et al (2008) Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement. Conclusions: Following knee hyperextension, bone bruising patterns may be associated with cruciate ligament injury. Orthopedic radiology Philadelphia, Pa: Saunders, 1986; 502, 511. A knee contusion can usually be treated . High signal well within the intercondylar notch with a partial-thickness tear inferiorly of the femoral insertion of the posterior cruciate ligament (best see on the coronal sequence). Our results therefore suggest that kissing contusions are more common following knee hyperextension than in other forms of knee injury and predominantly affect the medial side. PubMed Central Exclusion criteria were history of any infection, surgery or neoplasm of knee joint, patients having any prosthetic heart valve implant, any pacemaker implant, aortic stent graft, cochlear implant or any metallic orthopedic implants, any joint replacement surgery and claustrophobic patients. (2008) ISBN:0323076211. Google Scholar. N Z Med J. Kirialanis P, Malliou P, Beneka A, Giannakopoulos K. Occurrence of acute lower limb injuries in artistic gymnasts in relation to event and exercise phase. The clip injury results in a prominent area of edema involving the lateral femoral condyle and a smaller area of edema involving the medial femoral condyle. Multi-vendor multi-site quantitative MRI analysis of cartilage degeneration 10Years after anterior cruciate ligament reconstruction: MOON-MRI protocol and preliminary results. PMC This pattern is thought to result resolution from contrecoup forces in the medial compartment at the forced valgus forces. Br J Sports Med. 2003;37:1379. To establish whether patterns of soft tissue injury following knee hyperextension are associated with post-traumatic 'bone bruise' distribution. Right knee injury was noted in 87 cases (63%) and left knee in 51 cases (37%). Meyer EG, Baumer TG, Haut RC. Study of imaging pattern in bone marrow oedema in MRI in recent knee injuries and its correlation with type of knee injury. Bone contusion patterns of the knee at MR imaging: footprint of the mechanism of injury. PubMed Mair SD, Schlegel TF, Gill TJ, Hawkins RJ, Steadman JR. Am J Sports Med. 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. Snearly WN, Kaplan PA, Dussault RG. Correspondence to Bone contusion of knee: Increase lesion detection with fast spin echo MR Imaging with spectroscopic Fat saturation. J Bone Joint Surg Am. Pivot shift pattern is most common contusion pattern and the most common type/mode of sports related injury. All the patients underwent magnetic resonance imaging (MRI) preoperatively, and the diagnosis was confirmed with the aid of arthroscopy. For KC, the corresponding values were 36.6% and 99.4%, respectively. PubMed Pivot shift pattern is most common contusion pattern and the most common type/mode of injury is sports related injury. No fractures were present on x ray. Contusions of both surfaces of the joint are known as kissing contusions.Objective: To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint.Methods: 255 MRI examinations in athletes with acutely injured knees (197 men; 58 women; Related Papers {"url":"/signup-modal-props.json?lang=us"}, Knipe H, Hyperextension knee injury. T2 Axial: Bone marrow oedema in Inferiomedial aspect of patella and lateral femoral condyle in lateral patellar dislocation. 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. Bisson LJ, Kluczynski MA, Hagstrom LS, Marzo JM. An official website of the United States government. Inpatient imaging services are available 24/7. Tensile load can cause ligament and tendon tears as well as avulsion fracture. There were high rates of injury to the posterior capsule (52%), ACL (40%) and PCL (40%) but lower rates of injury to the menisci (20%), medial and lateral collateral ligaments (16%) and posterolateral corner (16%). severe contusions may cause the knee to give out or lock. Kapelov RS, Terris LM, Bradley WG, Bucciarelli NR, Murakami DM, Mullin WJ, et al. PDFS Coronal: Bone marrow contusion at lateral femoral condyle and lateral tibial plateau in Pivot shift injury pattern. Oedema is seen at the anterior aspect of the tibia and, occasionally, at the posterior surface of the patella [8]. Follow up scan could not be done to establish the presumable diagnosis of bone marrow contusion. Price excludes VAT (USA) The datasets used or analysed during the current study are available from the corresponding author on reasonable request. AJR Am J Roentgenol. These contusions are generally found by magnetic resonance imaging and most cases are associated with ligamentous or menisceal injuries. and transmitted securely. Google Scholar. Radiology 184(3):855858, Dimitriou D, Reimond M, Foesel A et al (2021) The deep lateral femoral notch sign: a reliable diagnostic tool in identifying a concomitant anterior cruciate and anterolateral ligament injury. Hayes CW, Brigido MK, Jamadar DA, Propeck Tim. Bone contusions are often identified at magnetic resonance imaging (MRI) in the acutely injured knee. Am J Sports Med. Arch Orthop Trauma Surg. Traumatic bone bruising-a review article. Federal government websites often end in .gov or .mil. 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. Google Scholar, Berthold DP, Muench LN, Herbst E et al (2021) High prevalence of a deep lateral femoral notch sign in patients with anterior cruciate ligament (ACL) and concomitant posterior root tears of the lateral meniscus. Bone Marrow Signal Alteration in the Extremities. Soft tissue abnormalities may include injury of ACL or PCL and a meniscal injury along with injury of the popliteal neurovascular structure, complete disruption of the posterolateral complex, gastrocnemius injury [8]. Careers, Unable to load your collection due to an error. 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. Our Facilities. PubMed Central -, Am J Sports Med. Analysis of bone marrow oedema was done by a single observer based on MRI [9], its patterns were studied and possible type/mode of injury was determined before elucidating the history from the patient. A load that is too low to cause cortical fracture may be sufficient to disrupt trabecular bone and produce marrow contusion. Call Us Today! -, Radiology. Before Epub 2019 Mar 26. 2014 Feb;44(2):281-93. doi: 10.1007/s40279-013-0116-z. 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. 35 0 obj It is a common injury that can occur from a fall, blow, or collision. Bone contusion is also noted in posterior lip of the medial tibial condyle [8] or medial femoral condyle and medial tibial condyle [7]. 2022 Oct;30(10):3508-3514. doi: 10.1007/s00167-022-06970-z. Five patterns of bone marrow contusion was noted in 138 cases: Clip injury in 39 cases (28.3%) [Table/Fig-1a&b], Pivot shift injury in 78 cases (56.5%) [Table/Fig-2a&b], Dashboard injury in eight cases (5.8%) [Table/Fig-3], Hyper extension injury in four cases (2.9%) [Table/Fig-4], Lateral patellar dislocation in three cases (2.2%) [Table/Fig-5]. This mechanism of injury involves other soft tissue structures like tears/posterior capsule and arcuate ligament, medial collateral ligament (MCL) and the menisci. https://doi.org/10.1007/s00256-017-2754-y, https://doi.org/10.1016/j.arthro.2016.03.015. Rangger C, Kathrein A, Freund MC, Klestil T, Kreczy A. Study was conducted between May 2014 to September 2015 with sample size of 200 patients, after taking the institutional ethical clearance. Unable to load your collection due to an error, Unable to load your delegates due to an error. Bisson LJ, Kluczynski MA, Hagstrom LS, Marzo JM. Conclusions: *no pattern of bone marrow contusion could be explained as per the classification. endobj Arch Orthop Trauma Surg 139(6):807816, Fayad LM, Parellada JA, Parker L, Schweitzer ME (2003) MR imaging of anterior cruciate ligament tears: is there a gender gap? 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. Am J Sports Med. Clin Sports Med 33(4):633640, Tauber M, Fox M, Koller H, Klampfer H, Resch H (2008) Arthroscopic treatment of a large lateral femoral notch in acute anterior cruciate ligament tear. Computed Tomography & Magnetic Resonance Imaging Of The Whole Body. MR diagnosis of Bone contusion of the knee: Comparison of coronal T2 weighted Fast spin echo with fat saturation and fast spin echo STIR images with conventional STIR images. 2000;20 Spec No (suppl_1): S135-51. Correlation between various pattern of bone marrow oedema and type/mode of injury. 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 Results are comparable to the study conducted by Kaplan et al., in which bone marrow contusion at posterior lip of medial tibial condyle was seen in 25 out of 215 cases (11.6%) and contusion in lateral compartment was noted in 24 out of 25 cases (96%) and contusion at medial femoral condyle was seen in 5 in 25 cases (20%) [7]. XZ contributed to part of the statistics of the article. They can be used to diagnose ACL injuries. Sanders TG, Medynski MA, Feller JF, Lawhorn KW. Following knee hyperextension, bone bruising patterns may be associated with cruciate ligament injury. Pivot shift injury pattern according to Location of marrow oedema. 10 0 obj Contusions of both surfaces of the knee joint are known as kissing contusions. Unauthorized use of these marks is strictly prohibited. Mild high signal of the distal semimembranosus insertion, however, the remaining posteromedial corner structures appear uninjured. Hyperextension results in the "kissing" contusion pattern involving the anterior aspect of the proximal tibia and distal femur. In six cases (4.3%) no pattern of bone marrow contusion could be explained and was categorized as unclassified pattern [Table/Fig-6]. At the time the article was created Henry Knipe had no recorded disclosures. The .gov means its official. government site. Am J Sports Med. 98 0 obj The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS).

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