Diagnosis of partial tears of the anterior cruciate ligament of the knee: value of MR imaging.

Umans, Hilary; Wimpfheimer, Orit; Haramati, Nogah; Applbaum, Yaakov; Adler, Micha; Bosco, Joseph

doi:10.2214/ajr.165.4.7676988

Cited by 157 publications

(96 citation statements)

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“…While MRI can be a useful adjunct in making an accurate diagnosis with a complete ACL tear, reports have shown poor sensitivity of MRI in detecting partial ACL tears [16,17] (Fig. 2).…”

Section: Examinationmentioning

confidence: 99%

Pediatric ACL injuries: evaluation and management

Mall¹,

Paletta

2013

Curr Rev Musculoskelet Med

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The anterior cruciate ligament (ACL) is a stabilizing structure to both anterior translation of the tibia with respect to the femur as well as rotation of the knee joint. Children and adolescents are susceptible to these injuries, and there are some who believe the incidence of ACL injuries in this population is increasing due to year round single sport participation. Pediatric ACL injuries are typically seen in several forms: tibial avulsion fractures, partial ACL tears, and full thickness ligament tears. There were and still are some who feel that ACL injuries should be treated non-operatively in the pediatric and adolescent population; however, recent literature refutes this notion. Several factors must be considered during pediatric and adolescent ACL reconstruction, each of which will be examined in this manuscript, including: status of the physis, reconstruction technique, and graft source.

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“…While MRI can be a useful adjunct in making an accurate diagnosis with a complete ACL tear, reports have shown poor sensitivity of MRI in detecting partial ACL tears [16,17] (Fig. 2).…”

Section: Examinationmentioning

confidence: 99%

Pediatric ACL injuries: evaluation and management

Mall¹,

Paletta

2013

Curr Rev Musculoskelet Med

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“…Although some studies have reported that MRI is sensitive and specific for diagnosing complete ACL rupture [7,20,26,28], other studies reported limited diagnostic value of MRI for distinguishing between partial and complete ACL tears [10,[27][28][29]. Furthermore, clear discrimination of the two bundles of ACL can sometimes be difficult [22].…”

Section: Discussionmentioning

confidence: 99%

“…These three categories were determined based on previously reported MRI criteria of ACL injury (Figs. 5-7) [18,[27][28][29]. Completely torn was defined as a failure to visualize the ACL.…”

Section: Mri Protocol and Interpretation (77 Knees)mentioning

confidence: 99%

“…Increased signal intensity within the ligament substance, distortion of fibers, and significant thinning of the bundles without obvious discontinuity were all defined as attenuated (Fig. 6) [17,[27][28][29]. In contrast, an ACL bundle that could be followed continuously with homogeneous low signal intensity from the tibial and to the femoral insertions was defined as intact ( Fig.…”

Section: Mri Protocol and Interpretation (77 Knees)mentioning

confidence: 99%

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How Useful Is MRI in Diagnosing Isolated Bundle ACL Injuries?

Chang

Choi

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Selective bundle anterior cruciate ligament (ACL) reconstruction and/or remnant ACL preservation may be reasonable options for some patients. However, the frequency of isolated anteromedial (AM) or posterolateral (PL) bundle injuries in patients undergoing ACL reconstruction is unknown, and the value of MRI for prediction of this injury pattern is likewise unknown. Questions/purposes We sought to determine (1) the proportion of knees with an intact AM or PL bundle in patients undergoing ACL reconstruction; (2) whether MRI predicted the bundle conditions seen at the time of surgery; and (3) whether the accuracy of the MRI prediction was affected by the timing of MRI after injury. Methods During primary ACL reconstructions of 156 knees, conditions of AM and PL bundles were separately examined and classified into three categories: (1) completely torn; (2) attenuated; and (3) intact. Then, the bundles were assessed by blinded observers on MRI and classified into the corresponding three categories for 77 patients who had an MRI at our institution using a standard protocol. Diagnostic accuracy of MRI was computed, and the early MRI group (B 6 weeks from injury to MRI acquisition) was compared with the late MRI group ([6 weeks). Results Only 11 (7%) of the 156 knees we treated had an intact AM (one knee) or PL bundle (10 knees). Another 55 knees (35%) had a structurally continuous but attenuated AM or PL bundle. The overall diagnostic accuracy of MRI was 83%; accuracy was better for the AM bundle than the PL bundle (91% versus 78%; p = 0.026). MR prediction was less accurate in the early MRI group, particularly for PL bundle injury.

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“…While acute complete ACL tears generally present no diagnostic challenge with MRI, partial-thickness tears can be more problematic [46,47]. Partial-thickness tears may be seen on MRI as mild bowing of the ligament [46].…”

Section: Anterior Cruciate Ligamentmentioning

confidence: 99%

Magnetic resonance imaging in the evaluation of ligament injuries

Farooki¹,

Seeger²

1999

Skeletal Radiology

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Magnetic resonance imaging has had a dramatic effect on the means by which we diagnose ligament injuries. Tears resulting from either acute trauma or overuse can be detected noninvasively, directing appropriate therapy be it conservative or surgical. For the elite athlete, earlier diagnosis leads to earlier intervention, or alternatively, a normal MRI examination can result in an earlier return to play. While MRI is accepted for the diagnosis of certain injuries such as complete tears of the cruciate ligaments of the knee, other injuries, such as partial cruciate ligament tears or tears of the intercarpal ligaments of the wrist, remain controversial.

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Diagnosis of partial tears of the anterior cruciate ligament of the knee: value of MR imaging.

Abstract: OBJECTIVE.The purpose of our study was to assess the ability of MR

Cited by 157 publications

References 0 publications

Pediatric ACL injuries: evaluation and management

Pediatric ACL injuries: evaluation and management

How Useful Is MRI in Diagnosing Isolated Bundle ACL Injuries?

Magnetic resonance imaging in the evaluation of ligament injuries

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