;S'XhM. PubMed Twenty-five patients were identified (median time from injury to MRI = 24 days). FOIA Bratisl Lek Listy 113(9):539543, Svoboda SJ (2014) ACL injury and posttraumatic osteoarthritis. 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. This site needs JavaScript to work properly. Bone bruise represents as acute, occult microfractures of subchondral trabecular bone with subsequent haemorrhage, oedema and hyperemia. 2012;2 (5): 398-402. sharing sensitive information, make sure youre on a federal 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 lateral femoral notch sign following ACL injury: frequency, morphology and relation to meniscal injury and sports activity. PDFS Coronal: Bone marrow oedema at Medial femoral condyle and Metadiaphysis. 1989 Jun;171(3):761-6 Bone marrow contusions are frequently identified at magnetic resonance imaging after an injury to the musculoskeletal system, and the mechanism of injury can be determined by studying the distribution of bone marrow edema, which enables one to predict with accuracy the specific soft-tissue abnormalities that are likely to be present. 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 location of bone marrow oedema and the presence of other trauma related findings. -, Acta Orthop Scand. Table showing Type/Mode of injury in pivot shift injury. Bookshelf Unauthorized use of these marks is strictly prohibited. Inclusion in an NLM database does not imply endorsement of, or agreement with, 1998 Jun;69(3):291-4 4. The authors declare that they have no conflict of interest. 2015;23(8):22508. https://doi.org/10.1007/s00256-017-2754-y, https://doi.org/10.1016/j.arthro.2016.03.015. Part of Springer Nature. Epub 2013 Jun 6. Am J Sports Med. Biomechanical Approach to MRI of Acute Knee Injuries. The magnitude of the force is a major determinant of the imaging findings. 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]. doi: 10.2106/JBJS.OA.21.00069. 35 0 obj MRI follow-up of posttraumatic bone bruises of the knee in general practice. J Clin Diagn Res. Over the lifetime, 3 publication(s) have been published within this topic receiving 31 citation(s). Patients with a knee MRI within one year of hyperextension injury were identified at our institution over a 7 year period. 2023 Springer Nature Switzerland AG. Boks SS, Vroegindeweij D, Koes BW, Bernsen RM, Hunink MG, Bierma-Zeinstra SM. 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. 2008;67:5461. Bone marrow contusion is transient dislocation of patella noted in anterior aspect of lateral femoral condyle and inferiomedial aspect of patella in all the cases (100 %). Orthop Surg. Pure passive hyperextension of the human cadaver knee generates simultaneous bicruciate ligament rupture. The most common symptom of a knee contusion is pain. Conclusions: Federal government websites often end in .gov or .mil. While the knee is in a state of flexion, twisting motion of the knee can lead to transient dislocation of knee. MRIs, plain radiographs and clinical details of these patients were reviewed. Skeletal Radiol 47, 173179 (2018). 8600 Rockville Pike No funding was received to assist with the preparation of this manuscript. Patient was placed in supine position with knee externally rotated 10-20 degree 21. Hayes CW, Brigido MK, Jamadar DA, Propeck Tim. Article 21033-6-01). {"url":"/signup-modal-props.json?lang=us"}, Knipe H, Yap J, Al Kabbani A, et al. 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]. endobj Bone Bruise Distribution Patterns After Acute Anterior Cruciate Ligament Ruptures: Implications for the Injury Mechanism. "Kissing contusions," a commonly seen secondary sign of ACL injury caused by the previously mentioned pivot-shift mechanism of injury, occur on the posterior aspect of the tibial plateau and the mid to anterior aspect of the femoral condyle (Figure 4). 1 0 obj PubMedGoogle Scholar. 1998;69:2914. Eur J Orthop Surg Traumatol. Hong CK, Lin YJ, Cheng TA, Chang CH, Hsu KL, Kuan FC, Su WR. ADVERTISEMENT: Supporters see fewer/no ads. Age, type of bone bruise, and number of bruises also have prognostic value. Twenty of the 23 patients had follow-up imaging. The posteromedial corner of the knee is a capsuloligamentous complex in the posterior aspect of the medial compartment. Conclusions: 1995;19:7736. A 14-year-old male football player with chronic anterior knee pain who experienced acute knee pain after jumping and landing awkwardly. A lateral radiograph of the right knee a shows osseous fragmentation of the tibial tuberosity and soft tissue swelling ( white arrow ). 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. Bone Marrow Edema Injury Patterns in the Pediatric Knee: An MRI Study. 2011;93:15108. Unable to load your collection due to an error, Unable to load your delegates due to an error. In addition to trauma, marrow oedema can be seen in a broad spectrum of entities, including infection, transient osteoporosis of the hip bone marrow, and neoplasm demonstrates relatively hyperintense T2 and hypointense T1 signal, but the clinical history and location of injury typically allows the correct diagnosis to be made [2]. On analysing the bone marrow contusion pattern, type/mode can be determined in most of cases. Follow-up of occult bone lesions detected at MR imaging: systematic review. 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. Department of Radiology, Wilford Hall Medical Center, 759th MDTS/MTRD, 2200 Bergquist Dr, Ste 1, Lackland AFB, TX 78236-5300, USA. Location of bone bruises and other osseous injuries associated with acute grade III isolated and combined posterolateral knee injuries. 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. Patel SA, Hageman J, Quatman CE, Wordeman SC, Hewett TE. 2020 Apr 15;8(4):2325967120911162. doi: 10.1177/2325967120911162. LXC designed the study and was responsible for the paper. On applying fisher-exact test, p = 0.1655 i.e. Google Scholar. Careers. AJR Am J Roentgenol. This study was approved by the ethical committee of Beijing Tsinghua Changgung Hospital (No. Sanders TG, Medynski MA, Feller JF et-al. The pattern of bone bruise in knee injuries (a.k.a. A. M. Ali. E-mail: Received 2016 Jan 13; Revisions requested 2016 Jan 29; Accepted 2016 Feb 28. PubMed Central Although patients often present to the emergency department with acute knee pain and hemarthrosis, spontaneous reduction frequently occurs, and half of cases are unsuspected clinically. Notch syndrome refers to the enlarged and deepened lateral femoral condyle. 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 saggital plane was primarily used to evaluate the bone marrow oedema which was confirmed on coronal images. This injury most commonly occurs when the knee strikes against the dashboard during an automobile accident or fall against the ground on flexed knee. Notch depth equal to 0.72mm can be basically considered as the optimal cut-off point for LFNS in statistics. Bone bruising of the knee. Patient demographics, the clinical presentation, and the role of trauma are critical for . "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. Bone bruise in the acutely injured knee. khloe kardashian hidden hills house address. The knee is a major weight bearing joint that provides mobility and stability during physical activity as well as balance while standing. 2011 Aug 17;93(16):1510-8. doi: 10.2106/JBJS.J.01320. judge timothy kenny political affiliation. <> 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);. Federal government websites often end in .gov or .mil. Kissing contusion refers to the bone contusions in both femoral and tibial surfaces of the knee. 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. T1W Saggital: Bone marrow oedema at Lateral femoral condyle in Clip injury pattern. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Skeletal Radiology Application of valgus load to the knee in various degree of flexion combined with external rotation of the tibia or internal rotation of the femur lead to pivot shift injury resulting in disruption of Anterior Cruciate Ligament (ACL). 2004;38:5926. Bethesda, MD 20894, Web Policies 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. The spectrum of damage includes stretching, partial tearing, and complete rupture [4]. In suspected ACL injury, bone marrow contusion may not be necessarily present. 2021 Nov 11;6(4):e21.00069. 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. Am J Sports Med. Our team of experienced agents will hand hold the member through theentireprocess. The patients age ranged from 17-65 years and majority of patients were in 21-30years age group. Nippon Igaku Hoshasen Gakkai Zasshi 55(6):375379, CAS The datasets used or analysed during the current study are available from the corresponding author on reasonable request. A knee contusion can range from mild to severe. 36 0 obj Am J Sports Med. Sports Med. Correlation between various pattern of bone marrow oedema and type/mode of injury are shown in [Table/Fig-17]. 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%). Google Scholar, Wierer G, Simetinger T, Hudelmaier M, Moroder P, Hoffelner T (2020) Fate of the lateral femoral notch following early anterior cruciate ligament reconstruction. Therefore, an influence by the number of bone bruises on healing time was marked; the higher the number, the more likely that there will be one slowly resolving lesion. Posterior tibial bone bruising associated with posterior-medial meniscal tear in patients with acute anterior cruciate ligament injury. Case Discussion. Am J Sports Med. Our Facilities. Inclusion criteria were patients with recent knee injuries (<6weeks) and normal plain radiograph with no signs of pathology. Patients were scanned using 1.5 Tesla Seimens Avanto (Tim + Dot) with Tx/Rx 15 channel knee coil # Tim. Radiographics : a Review Publication of the Radiological Society of North America, Inc , 01 Oct 2000, 20 Spec No: S135-51. This was comparable to study conducted by Kirsch et al., in who reported transient lateral patellar dislocation in 2% cases with acute knee injuries and bone marrow contusion is noted in lateral femoral condyle in 81% and contusion in patella in 19% cases [15]. Meniscal injury was unrelated to the extent or pattern of bone bruising. At the time the case was submitted for publication Henry Knipe had no recorded disclosures. MacMahon PJ, Palmer WE. Acta Radiol. {"url":"/signup-modal-props.json?lang=us"}, Knipe H, Hyperextension knee injury. 2000;20:S13551. eCollection 2021 Oct-Dec. Liu ZY, Zhang JL, Zhang T, Cao Q, Zhao JC, Li EQ, Shen QJ, Zhao BC, Zheng YC, Chen Y. Orthop Surg. Pivot shift pattern is most common contusion pattern and the most common type/mode of sports related injury. In six cases (4.3%) no pattern of bone marrow contusion could be explained and was categorized as unclassified pattern [Table/Fig-6]. ADVERTISEMENT: Supporters see fewer/no ads. 2011;68:7626. In this study, patients with history of knee injury <6 weeks were considered as recent knee injuries. -, Am J Sports Med. These lesions also referred to as bone bruises, are presumably the result of microfracture of the medullar trabecula [5]. The LFNS and KC have strong clinical significance in the diagnosis of ACL injuries. Knee Surg Sports Traumatol Arthrosc 29(6):19681976, Egloff C, Huber L, Wurm M, Pagenstert G (2019) No added value using SPECT/CT to analyze persistent symptoms after anterior cruciate ligament reconstruction. This is a preview of subscription content, access via your institution. A thorough understanding of knee injury patterns and their mechanisms may help achieve more accurate assessment of injuries [8]. 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. A deeper notch often indicates a more complex knee injury. In total 200 cases, bone marrow contusion was noted in 138 cases (69%) and absent contusion in 62 cases (31%). PDFS Saggital: Bone marrow oedema at proximal tibia in Dashboard injury. (2008) ISBN:0323076211. Bone contusion and associated meniscal and medial collateral ligament injury in patients with anterior cruciate ligament rupture. Knee Surg Sports Traumatol Arthrosc. Archives of Orthopaedic and Trauma Surgery 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. 8600 Rockville Pike Clinical outcome of isolated subcortical trabecular fractures (bone bruise) detected on magnetic resonance imaging in knees. SuzanneWitjes, Tammo HPels Rijcken, Cor Pvan der Hart. Deangelis JP, Spindler KP. Bone marrow oedema of the knee may cause substantial clinical entities, as they cause acute pain and functional loss in the joint. HSS J. Assessment with magnetic resonance, correlated with arthroscopy. 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. 2013 Aug;41(8):1801-7. doi: 10.1177/0363546513490649. PubMed Horizontal Rafting Plate for Treatment of the Tibial Plateau Fracture. [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). the contents by NLM or the National Institutes of Health. Minor focus of edema in the anterior aspect of the lateral femoral condyle. bone bruises on magnetic resonance imaging evaluation of anterior cruciate ligament injuries. Before NAME, ADDRESS, E-MAIL ID OF THE CORRESPONDING AUTHOR: Dr. Ashish Garg, A-4, Ashok Nagar, Mandoli Road, Shahdara, Delhi-110093, India. The presence of a double sulcus showed significant association with anteromedial kissing contusions (OR = 7.8, p = 0.03). MeSH Other structures are injured less frequently and have weaker associations with bone bruise distribution. Bone contusions of the knee: increased lesion detection with fast spin-echo MR imaging with spectroscopic fat saturation. PDFS Saggital: Bone marrow oedema at Lateral femoral condyle in Clip injury pattern. 2011 Aug 17;93(16):1510-8. doi: 10.2106/JBJS.J.01320. Expansive network access, savings and no red tape An absolute win-win foreveryone! Bone contusion of knee: Increase lesion detection with fast spin echo MR Imaging with spectroscopic Fat saturation. Moderate edema at the gastrocnemius/soleus interface and overlying the superficial medial gastrocnemius proximal myotendinous junction. Language links are at the top of the page across from the title. Bretlau T, Tuxe J, Larsen L, Jrgensen U, Thomsen HS, Lausten GS. Careers. To establish whether patterns of soft tissue injury following knee hyperextension are associated with post-traumatic bone bruise distribution. HW contributed to some imaging data and surgery. Results: 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). 1030). and transmitted securely. Type / Mode of injury in Clip injury pattern. 2016 Nov;32(11):2331-2341 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). 2016. https://doi.org/10.1016/j.arthro.2016.03.015. Other structures are injured less frequently and have weaker associations with bone bruise distribution. 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. 2023 Feb;19(1):107-112. doi: 10.1177/15563316221092320. Epub 2022 Nov 28. A total of 1000 patients were enrolled in this study, including 500 patients with ACL injuries who assigned to experimental group and 500 patients with meniscal tear (MT) who allocated to control group. Correspondence to 1993;21:2203. Kissing contusion is a(n) research topic. In current study unclassifiable injuries pattern was noted in 6 cases. *no pattern of bone marrow contusion could be explained as per the classification. 2004;32:16817. Archives of Orthopaedic and Trauma Surgery, https://doi.org/10.1007/s00402-022-04366-9. 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]. Other associated injury in ACL (87.5%), Medial meniscus (50 %) and lateral meniscus (75%). Pivot shift injury pattern according to Location of marrow oedema. 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. The https:// ensures that you are connecting to the Br J Sports Med. Bone marrow contusions are frequently identified at magnetic . 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). Unauthorized use of these marks is strictly prohibited. 2 Resident, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. Lianxu Chen. Oedema is seen at the anterior aspect of the tibia and, occasionally, at the posterior surface of the patella [8]. 2011;197 (3): 568-77. Article A 30-year-old woman with acute knee injury. Diagnostic value of the lateral femoral notch sign and kissing contusion in patients with anterior cruciate ligament injuries: a case-control study. PubMed Epub 2010 Sep 13. PubMed The usefulness of the oblique coronal plane in knee MRI on the evaluation of the posterior cruciate ligament. Radiology 182(1):221224, Niitsu M, Kuramochi M, Anno I, Itai Y (1995) Secondary signs of anterior cruciate ligament tear at MR imaging. Below is the link to the electronic supplementary material. An official website of the United States government. By applying a biomechanical approach in MR interpretation, it is possible to detect lesions like ligament rupture and osseous contusion, to predict subtle but it might overlook important abnormalities. 2021 May;13(3):966-978. doi: 10.1111/os.12997. Knee Surg Sports Traumatol Arthrosc. Magnetic resonance imaging of bone bruising in the acutely injured kneeshort-term outcome. -, Radiology. Google Scholar. Epub 2022 Mar 1. Hyperextension injuries of the knee: do patterns of bone bruising predict soft tissue injury?. 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]. endobj 2016;10(4):TC0611. Bone marrow edema and low T1 signal through the proximal tibial epiphysis anteriorly associated periosteal edema. CAS The most common sites of bone bruising were the anteromedial tibial plateau (48%) and anterolateral tibial plateau (44%). Book an Appointment. Radiology. In present study clip injury pattern is noted in 39 cases (28.6%). endobj 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). PubMed Diagnosis of bone marrow oedema following traumatic event prompt a closer inspection for lesions such as ligamentous and meniscal tears. <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB]/XObject<>>>/Rotate 0/TrimBox[57.25999 58.11 666.34 848.69299]/Type/Page>> [101 0 R] PubMed Mandalia V, Fogg AJB, Chari R, Murray J, Beale A, Henson JHL. 2014 . Skeletal Radiol 32(11):639646, Flint J, Wade A, Giuliani J, Rue J (2014) Defining the terms acute and chronic in orthopaedic sports injuries: a systematic review. KIS Imaging is the nations largest direct contracting imaging network with over 2,600 providers covering all major imaging needs: MRI, CT and PET. Bone bruise, Compressisve force, Early degeneration, Microfracture, Torsional force. We're here to help! Google Scholar. 2010 Dec;38(12):2502-8. doi: 10.1177/0363546510376232. bubble tea consumption statistics australia. Meniscal injury was unrelated to the extent or pattern of bone bruising. There has been limited investigation to subdividing the bone contusion model in the medial and lateral directions of the tibial plateau and the . JB JS Open Access. Epub 2021 May 11. 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.

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