Bone contusions of the knee: increased lesion detection with fast spin-echo MR imaging with spectroscopic fat saturation. PDF ORIGINAL ARTICLE The appearance of kissing contusion in the acutely Arch Orthop Trauma Surg 140(12):20132020, Article Google Scholar. Pivot shift pattern is most common contusion pattern and the most common type/mode of sports related injury. Bone Contusion Patterns of the Knee at MR Imaging: Footprint of the Looking for more information? It can also damage interposed soft tissues, most commonly the articular cartilage and meniscus. 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. 2023-05-01T23:01:26-07:00 2000 Nov-Dec;24(6):371-80 Before A prospective study of the association between bone contusion and intra-articular injuries associated with acute anterior cruciate ligament tear. 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. Radiographic features Five classic bone contusion patterns have been described 1-4: pivot-shift injury valgus stress to flexed and externally rotated knee 2011;197 (3): 568-77. The authors have no relevant financial or non-financial interests to disclose. PubMed Acta Orthop Traumatol Turc. Bratisl Lek Listy 113(9):539543, Svoboda SJ (2014) ACL injury and posttraumatic osteoarthritis. Perin B, Nardacchione R, Bonaga S, Angelini F, Girotto A, Giovagnoni A, et al. https://doi.org/10.1007/s00256-017-2754-y, DOI: https://doi.org/10.1007/s00256-017-2754-y. Knee Surg Sports Traumatol Arthrosc. 6 Resident, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. Imaging Services | HCA Valley Regional Medical Center | Valley Regional Most common location of marrow oedema in pivot shift pattern was posterolateral tibial plateau and lateral femoral condyle and medial tibial condyle and medial femoral condyle in 31 cases (39.7 %) [Table/Fig-9]. Radiology 182(1):221224, Niitsu M, Kuramochi M, Anno I, Itai Y (1995) Secondary signs of anterior cruciate ligament tear at MR imaging. Epub 2022 Apr 12. 2015;43(10):251521. Bone marrow oedema may also show delayed enhancement following administration of gadolinium DTPA. 35 0 obj 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. CAS Bisson LJ, Kluczynski MA, Hagstrom LS, Marzo JM. Study was conducted between May 2014 to September 2015 with a sample size of 200 patients. Hyperextension knee injury | Radiology Case | Radiopaedia.org At the time the article was created Henry Knipe had no recorded disclosures. Kaplan PA, Gehl RH, Dussault RG, Anderson MW, Diduch DR. 2023 Feb;19(1):107-112. doi: 10.1177/15563316221092320. Part of Springer Nature. Clinical outcome of isolated subcortical trabecular fractures (bone bruise) detected on magnetic resonance imaging in knees. Posteromedial Tibial Bone Bruise After Anterior Cruciate Ligament Injury: An MRI Study of Bone Bruise Patterns in 208 Patients. Bone marrow oedema of the knee may cause substantial clinical entities, as they cause acute pain and functional loss in the joint. Radiology. 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. Other 2 cases (50%) are hyperextension with valgus component and kissing contusion at medial aspect of proximal tibia and distal femur caused due to kicking while playing football. In our study pivot shift pattern is noted in 78 cases (56.5%). 2015;49:145260. They found that all the lesions in one patient do not heal at exactly the same speed. 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. 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. Jeli D, Masulovi D. Bone bruise of the knee associated with the lesions of anterior cruciate ligament and menisci on magnetic resonance imaging. Ciuffreda P, Lelario M, Milillo P, Vinci R, et al. Please enable it to take advantage of the complete set of features! Provided by the Springer Nature SharedIt content-sharing initiative, Over 10 million scientific documents at your fingertips, Not logged in On MR images, trabecular contusion has the appearance of bone marrow oedema. Acta Orthop Scand. Sanders TG, Medynski MA, Feller JF, Lawhorn KW. The clip injury is a contact injury that occurs after a pure valgus stress is applied to the knee while the knee is in a state of mild flexion (i.e. Orthop Surg. <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB]/XObject<>>>/Rotate 0/TrimBox[57.25999 58.11 666.34 848.69299]/Type/Page>> 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]. HHS Vulnerability Disclosure, Help MRI of affected knee joint was done as per imaging protocol and images stored in compact disc. Nippon Igaku Hoshasen Gakkai Zasshi 55(6):375379, CAS Bone bruise patterns in knee injuries: where are they found? Whilst anterolateral tibial plateau oedema strongly predicted PCL injury [OR=26.0, p=0.003], ACL injury was associated with a variable pattern of bone bruising. 1998;69:2914. Clin Imaging. The appearance of kissing contusion in the acutely injured knee in the 98 0 obj At the time the article was last revised Joshua Yap had A lateral radiograph of the right knee a shows osseous fragmentation of the tibial tuberosity and soft tissue swelling ( white arrow ). Orthop J Sports Med. Am J Sports Med. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. LXC designed the study and was responsible for the paper. The posteromedial corner of the knee is a capsuloligamentous complex in the posterior aspect of the medial compartment. MRI of Sports Injuries in Children and Adolescents: What's - Springer 1996 Sep;(330):133-42 Become a Gold Supporter and see no third-party ads. Traumatic mechanisms are sometimes too complex or poorly understood which cannot be comprehend [4]. endobj <> Results: Would you like email updates of new search results? MR feature of bone bruising reflects increase in water content in marrow cavity as a result of haemorrhage, therefore water sensitive sequence like fat saturated T2W, PD weighted image or STIR are used [1,11,12]. Transient lateral patellar dislocation: review of imaging findings 2008;67:5461. Transient lateral patellar dislocation: review of imaging findings 2014 . National Library of Medicine HHS Vulnerability Disclosure, Help Follow up scan could not be done to establish the presumable diagnosis of bone marrow contusion. Objective: To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint. Bone marrow oedema is responsible for patient symptoms and may lead to early degenerative changes [7]. Twenty-five patients were identified (median time from injury to MRI=24days). Calvo-Gurry M, Hurley ET, Withers D, Vioreanu M, Moran R. Knee Surg Sports Traumatol Arthrosc. Epub 2019 Mar 26. In many cases, Bone marrow contusion might have resolved at time of MRI. PubMed 1 Professor and HOD, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. Injury in PCL is seen in all the cases. Herbst E, Hoser C, Tecklenburg K, Filipovic M, Dallapozza C, Herbort M, et al. A thorough understanding of knee injury patterns and their mechanisms may help in achieving more accurate assessment of injuries. PubMed Central Patients with a knee MRI within one year of hyperextension injury were identified at our institution over a 7 year period. Bone marrow bruise is ill defined subchondral reticular or stellate region of low signal intensity on T1 and high signal intensity on T2W images [6]. Bone contusion of the posterior lip of the medial tibial plateau (contrecoup injury) and associated internal derangements of the knee. Additionally, the program is designed to drive true consumer engagement with waived out of pocket expenses and no pre-certification, which allows patients fast and efficient access to providers for their imaging needs. Type/Mode of injury were twisting injury while getting downstairs (1 case), twisting injury while doing household work (1 case) and injury while playing football (1 case). Hyperextension results in the "kissing" contusion pattern involving the anterior aspect of the proximal tibia and distal femur. Waldn M, Krosshaug T, Bjrneboe J, Andersen TE, Faul O, Hgglund M. Three distinct mechanisms predominate in non-contact anterior cruciate ligament injuries in male professional football players: a systematic video analysis of 39 cases. 2019 Nov;27(11):3633-3637. doi: 10.1007/s00167-019-05490-7. Federal government websites often end in .gov or .mil. An official website of the United States government. PMC Learn more about Institutional subscriptions. T1W Saggital: Bone marrow oedema at Lateral femoral condyle in Clip injury pattern. HSS J. . <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/TrimBox[57.25999 58.11 666.34 848.69299]/Type/Page>> -, Radiology. In this study, the time gap between injury and doing MRI was not considered. As a library, NLM provides access to scientific literature. Unable to load your collection due to an error, Unable to load your delegates due to an error. Bethesda, MD 20894, Web Policies 2011;133:011012. The most common sites of bone bruising were the anteromedial tibial plateau (48%) and anterolateral tibial plateau (44%). Multi-vendor multi-site quantitative MRI analysis of cartilage degeneration 10Years after anterior cruciate ligament reconstruction: MOON-MRI protocol and preliminary results. 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. sharing sensitive information, make sure youre on a federal A knee contusion can range from mild to severe. In this study 8 cases (5.7%) had dashboard injury pattern of bone marrow contusion at anterior aspect of proximal tibia. The double sulcus sign is a radiographic marker that confers a high probability of ACL injury. Snearly WN, Kaplan PA, Dussault RG. By directing imaging to outpatient sites, not hospital settings, it creates a better patient experience while yielding substantial savings. Epub 2021 Apr 4. Bone contusion is also noted in posterior lip of the medial tibial condyle [8] or medial femoral condyle and medial tibial condyle [7]. endobj Osteochondral Lesions of the Knee: Differentiating the Most Common Injury to the Meniscofemoral Portion of the Deep MCL Is Associated with Medial Femoral Condyle Bone Marrow Edema in ACL Ruptures. Mechanism-based pattern approach to classification of complex injuries of the knee depicted at mr imaging. Park HJ, Lee SY, Chung EC, Rho MH, Ahn JH, Kim M, et al. The .gov means its official. 2014 Feb;44(2):281-93. doi: 10.1007/s40279-013-0116-z. Conclusions: . Application of biomechanical approach in MR interpretation helps in effortless assessment of osseous contusion and ligament rupture and mark delicate but significant abnormalities. 2003;37:1379. of knee injury in pediatric patients. Rangger C, Klestil T, Kathrein A, Indester A, Hamid L. Influence of magnetic resonance imaging on indications for arthroscopy of the knee. 2000;20:S13551. According to study conducted by Terzidis et al., Kissing contusion in acute knee injury is noted in 16 cases out of 225 (7.1%). 5 out of 8 patients with a 'double sulcus' on the lateral radiograph had ACL injury. Bone Marrow Signal Alteration in the Extremities. The authors declare that they have no conflict of interest. https://doi.org/10.1007/s00256-017-2754-y, https://doi.org/10.1016/j.arthro.2016.03.015. A deeper notch often indicates a more complex knee injury. In current study unclassifiable injuries pattern was noted in 6 cases. Magnetic Resonance Imaging of Bone Marrow: A Review Part II. <> Analytical Services; Analytical Method Development and Validation Knee Surg Sports Traumatol Arthrosc. 5 0 obj endstream Inpatient imaging services are available 24/7. Eight of the kissing contusions were associated with anterior cruciate ligament tears, three with menisceal tears, four were isolated lesions, and one was delayed, following a menisceal tear. Below is the link to the electronic supplementary material. Kirsch MD, Fitzgerald SW, Friedman H, Rogers LF. Magnetic Resonance Imaging of Sports injuries of knee. The site is secure. 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). PubMed Central Bone contusion of knee: Increase lesion detection with fast spin echo MR Imaging with spectroscopic Fat saturation. Patients with a knee MRI within one year of hyperextension injury were identified at our institution over a 7 year period. 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]. Comparison of bone contusion seen by MRI in partial and complete tears of the anterior cruciate ligament. 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). Before Arthroscopy. MRIs, plain radiographs and clinical details of these patients were reviewed. The datasets used or analysed during the current study are available from the corresponding author on reasonable request. Archives of Orthopaedic and Trauma Surgery uuid:a4a67e17-1dd1-11b2-0a00-340827bd7200 Bone contusions of the posterior lip of the medial tibial plateau (contrecoup injury) and associated internal derangements of the knee at MR imaging. A knee contusion can usually be treated . Bookshelf Acrobat Distiller 5.0.5 (Windows) 1999 Jun;211(3):747-53 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. 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. If the knee is exposed to forces beyond its physiologic range, risk of injury to bone or soft tissue structures increases. Ryu KN, Jin W, Ko YT, Yoon Y, Oh JH, Park YK, et al. Adult patients with ACL tears have greater tibial internal rotation in MRI compared to adolescent patients. Location of bone marrow contusion in hyperextension injury (4 cases) was - medial tibial and medial femoral condyle (2 cases) and anterior aspect of proximal tibia and femur (2cases). 2022. endobj Knee joint is one of strongest joint in body and allows transmission of body weight to leg. 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]. Meyer EG, Baumer TG, Haut RC. Kissing contusion - Wikipedia Among 46 cases, football was most common sports leading to injury followed by Kabaddi. The spectrum of damage includes stretching, partial tearing, and complete rupture [4]. An official website of the United States government. On MR images, trabecular contusion has the appearance of bone marrow oedema. bone contusion) can give clues for the mechanism and associated injuries. In suspected ACL injury, bone marrow contusion may not be necessarily present. Our Facilities. Texas Health Care Imaging | Radiology Clinic in Brownsville, TX Song GY, Zhang H, Wang QQ, Zhang J, Li Y, Feng H. Bone contusions after acute noncontact anterior cruciate ligament injury are associated with knee joint laxity, concomitant meniscal lesions, and anterolateral ligament abnormality. 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%). Call Us Today! 2021 Nov 11;6(4):e21.00069. Br J Sports Med 38(5):592596, Article Grade II ACL tears represent intraligamentous injury and an increase in ligament length. Am J Sports Med. T2 Axial: Bone marrow oedema in Inferiomedial aspect of patella and lateral femoral condyle in lateral patellar dislocation. Other associated injury in ACL (87.5%), Medial meniscus (50 %) and lateral meniscus (75%). 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). volume143,pages 927934 (2023)Cite this article. 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. Knee Surg Sports Traumatol Arthrosc. Would you like email updates of new search results? 1996;198:2058. Associated MCL injury is noted in 31 cases (79.5%). Careers. Oedema or interisital fluid within marrow extracellular space similar to free fluid shows long T1 and T2 decay characteristics and appear hypointense on T1 and hyperintense on T2W. Unclassified injury pattern in 6 cases with type /mode of injury and location of bone marrow contusion. Eur J Orthop Surg Traumatol. Radiology. Twenty of the 23 patients had follow-up imaging. It typically occurs in teenagers and young adults involved in athletic activities. Google Scholar, Pao DG (2001) The lateral femoral notch sign. Am J Sports Med 28(1):6873, Gentili A, Seeger L, Yao L, Do H (1994) Anterior cruciate ligament tear: indirect signs at MR imaging. 10 0 obj Epub 2013 Jun 6. "The appearance of kissing contusion in the acutely injured knee in the athletes", https://en.wikipedia.org/w/index.php?title=Kissing_contusion&oldid=903873252, Creative Commons Attribution-ShareAlike License 3.0, This page was last edited on 28 June 2019, at 13:40. Careers. Clin Radiol. 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. Bone contusion patterns of the knee at MR imaging: footprint of the mechanism of injury. Diagnostic value of the lateral femoral notch sign and kissing contusion in patients with anterior cruciate ligament injuries: a case-control study. Study was conducted between May 2014 to September 2015 with sample size of 200 patients, after taking the institutional ethical clearance. Kapelov RS, Terris LM, Bradley WG, Bucciarelli NR, Murakami DM, Mullin WJ, et al. Gong, H., Wang, H., Zhang, X. et al. Accessibility Epub 2013 Jun 6. 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);. MeSH JB JS Open Access. MRI is used widespread to interpret more complex injuries. application/pdf government site. Correspondence to 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. The presence of a double sulcus showed significant association with anteromedial kissing contusions (OR = 7.8, p = 0.03). In this study, inclusion criteria included history of knee injury within 6 weeks or suspected ACL injury [12]. The lateral femoral notch sign (LFNS) and the kissing contusion (KC) are two indirect signs of anterior cruciate ligament (ACL) injuries. Bone contusion patterns of the knee at MR imaging: footprint of the mechanism of injury. https://doi.org/10.1007/s00402-022-04366-9, DOI: https://doi.org/10.1007/s00402-022-04366-9. Following knee hyperextension, bone bruising patterns may be associated with cruciate ligament injury. Bone bruise represents as acute, occult microfractures of subchondral trabecular bone with subsequent haemorrhage, oedema and hyperemia. Radiology. Yoon KH, Yoo JH, Kim KI. Plain radiograph of knee was done in all patients and they were scanned using 1.5 Tesla Seimens Avanto (Tim + Dot) with Tx/Rx 15 channel knee coil # Tim. 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). Skeletal Radiol 47, 173179 (2018). Google Scholar. 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. Soft tissue injury associated with dash board injury includes PCL and posterior joint capsule. 31 0 obj Book an Appointment. Clin Imaging. To establish whether patterns of soft tissue injury following knee hyperextension are associated with post-traumatic 'bone bruise' distribution. 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.
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