Bicompartmental Bucket Handle Meniscal Tear with Chronic ACL Deficiency Causing a Rare Triple PCL and Triple Cruciate Sign

Abstract

Case: A 16-year-old football player presented with chronic ACL deficiency along with bicompartmental bucket handle meniscal tears. Conclusion: We present a “triple cruciate” sign in addition to the triple posterior cruciate ligament (PCL) sign seen on Magnetic Resonance Imaging (MRI) to aid in diagnosing this injury.

Molar Tooth in the Knee – A Case of Simultaneous Medial and Lateral Bucket Handle Tear with Arthroscopic Correlation and a Review of Literature

“…Simultaneous occurrence of bucket handle tears of both menisci of the same knee is a rare occurrence with interesting and seldom viewed signs on MRI imaging. Few case reports of the same have been published in the literature ( Table 1 ) which shows that a sudden complex twisting injury of the knee results in this condition [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. In our case, the patient fell from a height, probably twisting his knee with the torque tearing both menisci of his left knee.…”

“…Koukoulias et al [ 7 ] reported a case with an accompanying medial cruciate ligament tear, while Lykissas et al [ 8 ] discussed a case with an associated chondral lesion of the medial femoral condyle with the latter resembling the finding in the index case. The youngest patient reported was a 16-year-old male reported by Sales et al [ 1 ] and the oldest were aged 38 years Koukoulias et al [ 7 ] and Wright et al [ 9 ]. Our patient is 1 year older.…”

“…Radiological diagnosis in each case was performed by an MR examination which displayed novel and interesting signs – triple PCL sign, quadruple cruciate sign, double anterior horn sign, truncated meniscus sign, and absent bow-tie sign [ 1 , 12 ]. With this case, we propose a new radiological sign on axial MRI images – the molar tooth sign which has not been previously described in the literature ( Fig.…”