Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Become a Gold Supporter and see no third-party ads. Hong CK, Hoshino Y, Watanabe S, Nagai K, Matsushita T, Su WR, Kuroda R. Knee Surg Sports Traumatol Arthrosc. NAME, ADDRESS, E-MAIL ID OF THE CORRESPONDING AUTHOR: Dr. Ashish Garg, A-4, Ashok Nagar, Mandoli Road, Shahdara, Delhi-110093, India. PubMed Our Facilities. After knee injury, bone marrow oedema is frequently subchondral in location [4]. They can be used to diagnose ACL injuries. A lateral radiograph of the right knee a shows osseous fragmentation of the tibial tuberosity and soft tissue swelling ( white arrow ). Bethesda, MD 20894, Web Policies While the knee is in a state of flexion, twisting motion of the knee can lead to transient dislocation of knee. 3 Professor, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. Am J Sports Med. Ready to get started? Rangger C, Klestil T, Kathrein A, Indester A, Hamid L. Influence of magnetic resonance imaging on indications for arthroscopy of the knee. Objective: Davies NH, Niall D, King LJ, Lavelle J, Healy JC. The classic bone contusion includes involvement of the antero-lateral aspect of the lateral femoral condyle and the inferomedial aspect of the patella. Bone contusion of the posterior lip of the medial tibial plateau (contrecoup injury) and associated internal derangements of the knee. Bone contusion and associated meniscal and medial collateral ligament injury in patients with anterior cruciate ligament rupture. Mechanism of traumatic knee injuries and MR findings. 1 Professor and HOD, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. 99 0 obj Bone contusions are often identified at magnetic resonance imaging (MRI) in the acutely injured knee. 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. see full revision history and disclosures, posterior soft tissue injuries involving the knee joint capsule, fibular attachment of soleus and distal semimembranosus tendon. -, Acta Orthop Scand. 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. sharing sensitive information, make sure youre on a federal Oedema is seen at the anterior aspect of the tibia and, occasionally, at the posterior surface of the patella [8]. It also was revealed that when the optimal cut-off point of LFNS was 0.72mm (area under the curve (AUC)=81%), the values of specificity and sensitivity were 67% and 84%, respectively. Sahoo K, Garg A, Saha P, Dodia JV, Raj VR, Bhairagond SJ. <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB]/XObject<>>>/Rotate 0/TrimBox[57.25999 58.11 666.34 848.69299]/Type/Page>> Inpatient imaging services are available 24/7. Radiographics : a Review Publication of the Radiological Society of North America, Inc , 01 Oct 2000, 20 Spec No: S135-51. {"url":"/signup-modal-props.json?lang=us"}, Knipe H, Hyperextension knee injury. 1998;69:2914. Objective: To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint. Hyperextension injuries of the knee: do patterns of bone bruising predict soft tissue injury?. It is a rare (6.3% in this series) but significant injury, often associated with ligamentous or menisceal tears. The usefulness of the oblique coronal plane in knee MRI on the evaluation of the posterior cruciate ligament. endobj A 14-year-old male football player with chronic anterior knee pain who experienced acute knee pain after jumping and landing awkwardly. Extensive posterior capsular edema in keeping with a hyperextension injury. No cost for the Employer or Employee with up to 80% savings. 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). A knee contusion can range from mild to severe. 5 0 obj Unauthorized use of these marks is strictly prohibited. Chi-square = 1.926, p =0.3817 i.e. Ali, A.M., Pillai, J.K., Gulati, V. et al. Radiol Med. Provided by the Springer Nature SharedIt content-sharing initiative, Over 10 million scientific documents at your fingertips, Not logged in Meyer EG, Baumer TG, Haut RC. In six cases (4.3%) no pattern of bone marrow contusion could be explained and was categorized as unclassified pattern. Following knee hyperextension, bone bruising patterns may be associated with cruciate ligament injury. Boks SS, Vroegindeweij D, Koes BW, Bernsen RM, Hunink MG, Bierma-Zeinstra SM. Unable to process the form. Kirsch MD, Fitzgerald SW, Friedman H, Rogers LF. Arch Orthop Trauma Surg 128(11):13131316, Terzidis IP, Christodoulou AG, Ploumis AL, Metsovitis SR, Koimtzis M, Givissis P (2004) The appearance of kissing contusion in the acutely injured knee in the athletes. The lateral femoral notch sign (LFNS) and the kissing contusion (KC) are two indirect signs of anterior cruciate ligament (ACL) injuries. In present study transient dislocation of patella pattern is noted in 3 cases (2.2%). Federal government websites often end in .gov or .mil. 5 out of 8 patients with a double sulcus on the lateral radiograph had ACL injury. CAS The site is secure. PubMedGoogle Scholar. -. Archives of Orthopaedic and Trauma Surgery, https://doi.org/10.1007/s00402-022-04366-9. Biomechanical and anatomical assessment after knee hyperextension injury. In our study, bone marrow oedema was seen in 138 cases (69%) out of 200 cases. Prevalence and location of bone bruises associated with anterior cruciate ligament injury and implications for mechanism of injury: a systematic review. Google Scholar. Hong CK, Lin YJ, Cheng TA, Chang CH, Hsu KL, Kuan FC, Su WR. 2019. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. The Predicted Position of the Knee Near the Time of ACL Rupture Is Similar Between 2 Commonly Observed Patterns of Bone Bruising on MRI. Kissing contusion is a(n) research topic. At the time the article was last revised Joshua Yap had The most common sites of bone bruising were the anteromedial tibial plateau (48%) and anterolateral tibial plateau (44%). Radiographic features Five classic bone contusion patterns have been described 1-4: pivot-shift injury valgus stress to flexed and externally rotated knee MRIs, plain radiographs and clinical details of these patients were reviewed. 2005;60:62736. This study was approved by the ethical committee of Beijing Tsinghua Changgung Hospital (No. Looking for more information? This mechanism of injury involves other soft tissue structures like tears/posterior capsule and arcuate ligament, medial collateral ligament (MCL) and the menisci. Twenty of the 23 patients had follow-up imaging. By directing imaging to outpatient sites, not hospital settings, it creates a better patient experience while yielding substantial savings. 2022 Jan 11;17(1):17. doi: 10.1186/s13018-022-02912-0. MRI of affected knee joint was done as per imaging protocol and images stored in compact disc. Furthermore, it is anterior tibial oedema rather than the presence of kissing lesions than predicts cruciate ligament injury (OR = 10.5, p = 0.02). 2004;32:16817. 2010 Dec;38(12):2502-8. doi: 10.1177/0363546510376232. J Bone Joint Surg Am. endobj The authors have no relevant financial or non-financial interests to disclose. Characteristic magnetic resonance imaging (MRI) findings often lead to the diagnosis. 2011;133:011012. PMC MRI of the Pediatric Knee Pediatric Imaging Review. HG contributed to the article writing and data collection. "Kissing contusion" refers to a bone contusion on both side of the knee joint. Kissing contusion refers to the bone contusions in both femoral and tibial surfaces of the knee. Acute findings of a joint effusion and posterior tibial plateau contusion are present. 1. The knee may also be swollen and bruised. In six cases (4.3%) no pattern of bone marrow contusion could be explained and was categorized as unclassified pattern [Table/Fig-6]. Bone contusion of knee: Increase lesion detection with fast spin echo MR Imaging with spectroscopic Fat saturation. The magnitude of the force is a major determinant of the imaging findings. 1020 AJR:196, May 2011 Pai and Strouse ulation [2, 3]. Magnetic Resonance Imaging of Bone Marrow: A Review Part II. The presence of a double sulcus showed significant association with anteromedial kissing contusions (OR = 7.8, p = 0.03). Background: Knee Surg Sports Traumatol Arthrosc 26(5):13991405, Lodewijks P, Delawi D, Bollen TL, Dijkhuis GR, Wolterbeek N, Zijl JAC (2019) The lateral femoral notch sign: a reliable diagnostic measurement in acute anterior cruciate ligament injury. Our imaging services center is on the 1st floor of the hospital, directly behind our main reception area. J Bone Joint Surg Am 92(2):353360, Yu JS, Bosch E, Pathria MN et al (1995) The deep lateral femoral sulcus:correlation in 124 patients with anterior cruciate ligament tear. Sanders TG, Medynski MA, Feller JF, Lawhorn KW. Clin Orthop Relat Res. Deangelis JP, Spindler KP. MR imaging performed in two patients with kissing contusions showed persistence of the tibial lesions. Mair SD, Schlegel TF, Gill TJ, Hawkins RJ, Steadman JR. According to study conducted by Terzidis et al., Kissing contusion in acute knee injury is noted in 16 cases out of 225 (7.1%). Would you like email updates of new search results? KIS Imaging is the nations largest direct contracting imaging network with over 2,600 providers covering all major imaging needs: MRI, CT and PET. no significant difference in location for different type/ mode of injury. Bone marrow edema and low T1 signal through the proximal tibial epiphysis anteriorly associated periosteal edema. Ryu KN, Jin W, Ko YT, Yoon Y, Oh JH, Park YK, et al. 2007;189:55662. Arch Orthop Trauma Surg 140(11):17511757, Article LF directed the writing of the article. In this study, the time gap between injury and doing MRI was not considered. Among the clip injury pattern, most common type/ mode of injury was two wheeler accident which was seen in 26 out of 39 cases (66.6%) [Table/Fig-7,,88]. Associated soft-tissue injuries include the medial retinaculum, the Medial Patellofemoral ligament, and the medial patellotibial ligament [9]. 2011;197 (3): 568-77. 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. In this study, inclusion criteria were acute knee injury only in athletes while in our study there were no such selection criteria. Bone marrow contusion at posterior lip of medial tibial condyle was seen in 59 cases. 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. Language links are at the top of the page across from the title. The relationship and characteristics between these two indicators was explored. 2006;238:85362. Clin Radiol. Kissing contusion is a significant injury often associated with ligamentous or menisceal injuries. These lesions also referred to as bone bruises, are presumably the result of microfracture of the medullar trabecula [5]. Knee Surg Sports Traumatol Arthrosc. The double sulcus sign is a radiographic marker that confers a high probability of ACL injury. FOIA Google Scholar, Kanakamedala AC, Burnham JM, Pfeiffer TR et al (2018) Lateral femoral notch depth is not associated with increased rotatory instability in ACL-injured knees: a quantitative pivot shift analysis. Pivot shift pattern is most common contusion pattern and the most common type/mode of injury is sports related injury. Conclusions: Following knee hyperextension, bone bruising patterns may be associated with cruciate ligament injury. The purpose of this review is to illustrate the MRI findings of lateral patellar dislocation and concomitant injuries, such as kissing contusions of the medial patella and lateral femoral condyle; osteochondral and avulsion fractures; and injuries of the medial patellofemoral ligament/retinacular complex. Resulting bone contusion pattern will be present in the posterior aspect of the lateral tibial plateau and midportion of the lateral femoral condyle near the condylopatellar sulcus. Analytical Services; Analytical Method Development and Validation Bone bruise of the knee: histology and cryosections in 5 cases. Acta Radiol. Due to superior ability to produce high resolution images with exquisite soft tissue contrast, MRI is the modality of choice for evaluation of bone marrow. Soft tissue injury associated with dash board injury includes PCL and posterior joint capsule. FOIA In 6 cases bone marrow contusion could not be explained by various patterns. PubMed Central severe contusions may cause the knee to give out or lock. 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. MacMahon PJ, Palmer WE. Federal government websites often end in .gov or .mil. 33 0 obj endobj Article Location of bone bruises and other osseous injuries associated with acute grade III isolated and combined posterolateral knee injuries. MacMahon PJ, Palmer WE. endstream Arch Orthop Trauma Surg. Bone contusion patterns of the knee at MR imaging: footprint of the mechanism of injury. 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. Sports Med. 2021 Nov 11;6(4):e21.00069. 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 XZ contributed to part of the statistics of the article. 1996;198:2058. Price excludes VAT (USA) This is a preview of subscription content, access via your institution. In suspected ACL injury, bone marrow contusion may not be necessarily present. 8600 Rockville Pike For KC, the corresponding values were 36.6% and 99.4%, respectively. Graf BK, Cook DA, De Smet AA, Keene JS. -, Am J Sports Med. The most common sites of bone bruising were the anteromedial tibial plateau (48%) and anterolateral tibial plateau (44%). Orthopedic radiology Philadelphia, Pa: Saunders, 1986; 502, 511. Epub 2013 Jun 6. Compressive load causes bone marrow contusion and, if sufficient in magnitude, depressed cortical fracture. HWnWhl2 p$%SgdR`Qvs4a^q~z]&O_F?`7%|8W.Zyxc\4x{gJSp>)nO|-6bhLCntyFTVe7WwtR?fs;fLh;>|*E{mIvqGUlT! Patient was placed in supine position with knee externally rotated 10-20 degree 21. Bretlau T, Tuxe J, Larsen L, Jrgensen U, Thomsen HS, Lausten GS. ;S'XhM. 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. Most common type / mode of injury in patients with unclassified pattern in fall from bike (3 cases) followed by hit by car/ motor vehicle (2 cases) and injury while lifting heavy weight in 1 case [Table/Fig-13]. The presence of a double sulcus showed significant association with anteromedial kissing contusions (OR=7.8, p=0.03). Pivot shift injury pattern according to Location of marrow oedema. ADVERTISEMENT: Supporters see fewer/no ads. 2000;24:37180. The most common symptom of a knee contusion is pain. Results: This is a preview of subscription content, access via your institution. Accessibility Unable to process the form. Skeletal Radiol 44(3):385391, Herbst E, Hoser C, Tecklenburg K et al (2015) The lateral femoral notch sign following ACL injury: frequency, morphology and relation to meniscal injury and sports activity. Incidence and location of bone bruises after acute posterior cruciate ligament injury. In this study, inclusion criteria included history of knee injury within 6 weeks or suspected ACL injury [12].