Multiligamentous Injury of the Knee: MRI Diagnosis and Injury Patterns

Abstract

Anterior cruciate and posterior cruciate injuries rarely occur in isolation and are often associated with injuries to the secondary or supporting structures that provide stability against rotational forces. These structures include the posterolateral and posteromedial corner ligaments and tendons, as well as the anterolateral ligament. If injuries to these secondary structures are not appreciated at the time of cruciate ligament reconstruction, an isolated cruciate ligament reconstruction may be predisposed to early failure. Thus it is crucial for radiologists interpreting knee magnetic resonance imaging to understand and report on injury to these ligaments and tendons at the time of initial injury to help the orthopaedic surgeon plan a comprehensive approach to ligament reconstruction. This strategy will ultimately result in improved patient outcomes.

Posteromedial Corner Injuries of the Knee: Imaging Findings

“…Injuries to the PMC structures are rarely isolated, occurring more frequently in patients with multiligamentous injuries in the context of acute knee trauma. 2,34 A typical mechanism of injury involving the components of the PMC is a trauma with combined force vector of valgus loading and external tibia rotation in knee flexion that can occur in sporting activities such as football, skiing, and ice hockey. 3,29,35 In contrast, a pure valgus force often tends to cause an isolated MCL injury.…”

Morphological variability of the leg muscles: potential traps on ultrasound that await clinicians

“…The anatomy of the secondary stabilizers of the knee can be presented in terms of corner-based anatomy, comprising the posterolateral corner (PLC), posteromedial corner and anterolateral corner [34,39,45]. The popliteus muscle and its tendon form one component of the PLC, and like other structures in this compartment, including the fibular collateral, arcuate, and fabellofibular ligaments, the posterolateral joint capsule and the popliteofibular ligament, the popliteus muscle has a complex, variable and imperfectly known anatomy.…”