MRI of Knee Joint Injury

Ramy Mansour; Mukherjee Kausik; Eugene McNally

doi:10.1055/s-2007-972002

Seminars in Musculoskeletal Radiology, Table of Contents

Semin Musculoskelet Radiol 2006; 10(4): 328-344
DOI: 10.1055/s-2007-972002

MRI of Knee Joint Injury

Ramy Mansour¹ , Mukherjee Kausik¹ , Eugene McNally¹

¹Department of Radiology, Nuffield Orthopaedic Centre, Oxford, United Kingdom

Abstract

ABSTRACT

Most knee injuries are the result of rotational, varus, valgus, hyperextension, or translational forces or a combination of these. The pattern of abnormalities seen on magnetic resonance imaging depends on the mechanism of trauma and the position of the joint at the time of injury. Knee injuries can be classified under two broad categories of direct and indirect injuries.

KEYWORDS

Knee injury - MRI - direct - indirect

Full Text

References

REFERENCES

1 Ostlere S. Imaging the knee. Imaging. 2003; 15 217-241
2 Kapelov S R, Teresi L M, Bradley W G et al.. Bone contusions of the knee: increased lesion detection with fast spin-echo MR imaging with spectroscopic fat saturation. Radiology. 1993; 189 901-904
3 Fracture and dislocation compendium. Orthopaedic Trauma Association Committee for Coding and Classification. J Orthop Trauma. 1996; 10(Suppl 1) v-ix 1-154
4 Mink J H, Deutsch A L. Occult cartilage and bone injuries of the knee: detection, classification, and assessment with MR imaging. Radiology. 1989; 170 823-829
5 Schatzker J, McBroom R, Bruce D. The tibial plateau fracture. The Toronto experience 1968-1975. Clin Orthop Relat Res. 1979; (138) 94-104
6 Bennett W F, Browner B. Tibial plateau fractures: a study of associated soft tissue injuries. J Orthop Trauma. 1994; 8 183-188
7 Yacoubian S V, Nevins R T, Sallis J G, Potter H G, Lorich D G. Impact of MRI on treatment plan and fracture classification of tibial plateau fractures. J Orthop Trauma. 2002; 16 632-637
8 Hautamaa P V, Fithian D C, Kaufman K R, Daniel D M, Pohlmeyer A M. Medial soft tissue restraints in lateral patellar instability and repair. Clin Orthop Relat Res. 1998; (349) 174-182
9 Sandmeier R H, Burks R T, Bachus K N, Billings A. The effect of reconstruction of the medial patellofemoral ligament on patellar tracking. Am J Sports Med. 2000; 28 345-349
10 Nomura E. Classification of lesions of the medial patello-femoral ligament in patellar dislocation. Int Orthop. 1999; 23 260-263
11 Sanders T G, Morrison W B, Singleton B A, Miller M D, Cornum K G. Medial patellofemoral ligament injury following acute transient dislocation of the patella: MR findings with surgical correlation in 14 patients. J Comput Assist Tomogr. 2001; 25 957-962
12 Spritzer C E, Courneya D L, Burk Jr D L, Garrett W E, Strong J A. Medial retinacular complex injury in acute patellar dislocation: MR findings and surgical implications. AJR Am J Roentgenol. 1997; 168 117-122
13 Hunter S C, Marascalco R, Hughston J C. Disruption of the vastus medialis obliquus with medial knee ligament injuries. Am J Sports Med. 1983; 11 427-431
14 Elias D A, White L M, Fithian D C. Acute lateral patellar dislocation at MR imaging: injury patterns of medial patellar soft-tissue restraints and osteochondral injuries of the inferomedial patella. Radiology. 2002; 225 736-743
15 Virolainen H, Visuri T, Kuusela T. Acute dislocation of the patella: MR findings. Radiology. 1993; 189 243-246
16 Sanders T G, Medynski M A, Feller J F, Lawhorn K W. Bone contusion patterns of the knee at MR imaging: footprint of the mechanism of injury. Radiographics. 2000; 20 Spec No S135-S151
17 Lance E, Deutsch A L, Mink J H. Prior lateral patellar dislocation: MR imaging findings. Radiology. 1993; 189 905-907
18 Kirsch M D, Fitzgerald S W, Friedman H, Rogers L F. Transient lateral patellar dislocation: diagnosis with MR imaging. AJR Am J Roentgenol. 1993; 161 109-113
19 Apostolaki E, Cassar-Pullicino V N, Tyrrell P N, McCall I W. MRI appearances of the infrapatellar fat pad in occult traumatic patellar dislocation. Clin Radiol. 1999; 54 743-747
20 Sonin A H, Fitzgerald S W, Friedman H et al.. Posterior cruciate ligament injury: MR imaging diagnosis and patterns of injury. Radiology. 1994; 190 455-458
21 Palmer W E, Kuong S J, Elmadbouh H M. MR imaging of myotendinous strain. AJR Am J Roentgenol. 1999; 173 703-709
22 Steinbach L S, Fleckenstein J L, Mink J H. Magnetic resonance imaging of muscle injuries. Orthopedics. 1994; 17 991-999
23 Shelbourne K DRB, Hunt S. Knee Injuries. Rosemont, IL; American Academy of Orthopaedic Surgeons 1999: 435-488
24 Indelicato P. Medial and Lateral Ligament Injuries of the Knee. New York; Churchill Livingstone 2001: 651-656
25 Hull M L. Analysis of skiing accidents involving combined injuries to the medial collateral and anterior cruciate ligaments. Am J Sports Med. 1997; 25 35-40
26 De Maeseneer M, Van Roy F, Lenchik L et al.. Three layers of the medial capsular and supporting structures of the knee: MR imaging-anatomic correlation. Radiographics. 2000; 20 83S-89
27 Warren L F, Marshall J L. The supporting structures and layers on the medial side of the knee: an anatomical analysis. J Bone Joint Surg Am. 1979; 61 56-62
28 Andriacchi T P. Knee Joint: Anatomy and Biomechanics. Rosemont, IL; American Academy of Orthopaedic Surgeons 2000: 239-247
29 White III A A, Raphael I G. The effect of quadriceps loads and knee position on strain measurements of the tibial collateral ligament. An experimental study on human amputation specimens. Acta Orthop Scand. 1972; 43 176-187
30 Lee J K, Yao L. Tibial collateral ligament bursa: MR imaging. Radiology. 1991; 178 855-857
31 Schweitzer M E, Tran D, Deely D M, Hume E L. Medial collateral ligament injuries: evaluation of multiple signs, prevalence and location of associated bone bruises, and assessment with MR imaging. Radiology. 1995; 194 825-829
32 Mink J H, Deutsch A L. Magnetic resonance imaging of the knee. Clin Orthop Relat Res. 1989; (244) 29-47
33 Sanders T G, Miller M D. A systematic approach to magnetic resonance imaging interpretation of sports medicine injuries of the knee. Am J Sports Med. 2005; 33 131-148
34 O'Donoghue D H. Surgical treatment of fresh injuries to the major ligaments of the knee. J Bone Joint Surg Am. 1950; 32 721-738
35 Resnick D. Diagnosis of Bone and Joint Disorders. 3rd ed. Philadelphia, PA; WB Saunders Co 1995
36 Stoller D W. Magnetic Resonance Imaging in Orthopaedics and Sports Medicine. 2nd ed. Philadelphia, PA; Lippincott Williams & Wilkins 1997
37 Girgis F G, Marshall J L, Monajem A. The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis. Clin Orthop Relat Res. 1975; (106) 216-231
38 Remer E M, Fitzgerald S W, Friedman H et al.. Anterior cruciate ligament injury: MR imaging diagnosis and patterns of injury. Radiographics. 1992; 12 901-915
39 Robertson P L, Schweitzer M E, Bartolozzi A R, Ugoni A. Anterior cruciate ligament tears: evaluation of multiple signs with MR imaging. Radiology. 1994; 193 829-834
40 Mink J H, Levy T, Crues III J V. Tears of the anterior cruciate ligament and menisci of the knee: MR imaging evaluation. Radiology. 1988; 167 769-774
41 Fitzgerald S W, Remer E M, Friedman H et al.. MR evaluation of the anterior cruciate ligament: value of supplementing sagittal images with coronal and axial images. AJR Am J Roentgenol. 1993; 160 1233-1237
42 Lee J K, Yao L, Phelps C T et al.. Anterior cruciate ligament tears: MR imaging compared with arthroscopy and clinical tests. Radiology. 1988; 166 861-864
43 Tung G A, Davis L M, Wiggins M E, Fadale P D. Tears of the anterior cruciate ligament: primary and secondary signs at MR imaging. Radiology. 1993; 188 661-667
44 Brandser E A, Riley M A, Berbaum K S, el-Khoury G Y, Bennett D L. MR imaging of anterior cruciate ligament injury: independent value of primary and secondary signs. AJR Am J Roentgenol. 1996; 167 121-126
45 Bari V, Murad M. Accuracy of magnetic resonance imaging in the knee. J Coll Physicians Surg Pak. 2003; 13 408-411
46 Winters K, Tregonning R. Reliability of magnetic resonance imaging of the traumatic knee as determined by arthroscopy. N Z Med J. 2005; 118 U1301
47 Vellet A D, Lee D H, Munk P L et al.. Anterior cruciate ligament tear: prospective evaluation of diagnostic accuracy of middle- and high-field-strength MR imaging at 1.5 and 0.5 T. Radiology. 1995; 197 826-830
48 Rubin D A, Kettering J M, Towers J D, Britton C A. MR imaging of knees having isolated and combined ligament injuries. AJR Am J Roentgenol. 1998; 170 1207-1213
49 Falchook F S, Tigges S, Carpenter W A, Branch T P, Stiles R G. Accuracy of direct signs of tears of the anterior cruciate ligament. Can Assoc Radiol J. 1996; 47 114-120
50 Huang G S, Lee C H, Chan W P et al.. Acute anterior cruciate ligament stump entrapment in anterior cruciate ligament tears: MR imaging appearance. Radiology. 2002; 225 537-540
51 Yao L, Lee J K. Avulsion of the posteromedial tibial plateau by the semimembranosus tendon: diagnosis with MR imaging. Radiology. 1989; 172 513-514
52 Kaplan P A, Gehl R H, Dussault R G, Anderson M W, Diduch D R. Bone contusions of the posterior lip of the medial tibial plateau (contrecoup injury) and associated internal derangements of the knee at MR imaging. Radiology. 1999; 211 747-753
53 Kaplan P A, Walker C W, Kilcoyne R F et al.. Occult fracture patterns of the knee associated with anterior cruciate ligament tears: assessment with MR imaging. Radiology. 1992; 183 835-838
54 Murphy B J, Smith R L, Uribe J W et al.. Bone signal abnormalities in the posterolateral tibia and lateral femoral condyle in complete tears of the anterior cruciate ligament: a specific sign?. Radiology. 1992; 182 221-224
55 Mellado J M, Calmet J, Olona M, Gine J, Sauri A. Magnetic resonance imaging of anterior cruciate ligament tears: reevaluation of quantitative parameters and imaging findings including a simplified method for measuring the anterior cruciate ligament angle. Knee Surg Sports Traumatol Arthrosc. 2004; 12 217-224
56 Chan W P, Peterfy C, Fritz R C, Genant H K. MR diagnosis of complete tears of the anterior cruciate ligament of the knee: importance of anterior subluxation of the tibia. AJR Am J Roentgenol. 1994; 162 355-360
57 Vahey T N, Hunt J E, Shelbourne K D. Anterior translocation of the tibia at MR imaging: a secondary sign of anterior cruciate ligament tear. Radiology. 1993; 187 817-819
58 Weber W N, Neumann C H, Barakos J A et al.. Lateral tibial rim (Segond) fractures: MR imaging characteristics. Radiology. 1991; 180 731-734
59 Schweitzer M E, Mitchell D G, Ehrlich S M. The patellar tendon: thickening, internal signal buckling, and other MR variants. Skeletal Radiol. 1993; 22 411-416
60 Umans H, Wimpfheimer O, Haramati N et al.. Diagnosis of partial tears of the anterior cruciate ligament of the knee: value of MR imaging. AJR Am J Roentgenol. 1995; 165 893-897
61 Lawrance J A, Ostlere S J, Dodd C A. MRI diagnosis of partial tears of the anterior cruciate ligament. Injury. 1996; 27 153-155
62 Fukubayashi T, Kurosawa H. The contact area and pressure distribution pattern of the knee. A study of normal and osteoarthrotic knee joints. Acta Orthop Scand. 1980; 51 871-879
63 Bourne R B, Finlay J B, Papadopoulos P, Andreae P. The effect of medial meniscectomy on strain distribution in the proximal part of the tibia. J Bone Joint Surg Am. 1984; 66 1431-1437
64 Ahmed A M. The Load-Bearing Role of the Knee Menisci. New York; Raven Press 1992: 190
65 Levy I M, Torzilli P A, Warren R F. The effect of medial meniscectomy on anterior-posterior motion of the knee. J Bone Joint Surg Am. 1982; 64 883-888
66 Messner K, Gao J. The menisci of the knee joint. Anatomical and functional characteristics, and a rationale for clinical treatment. J Anat. 1998; 193 161-178
67 Hsieh H H, Walker P S. Stabilizing mechanisms of the loaded and unloaded knee joint. J Bone Joint Surg Am. 1976; 58 87-93
68 King D. The function of semilunar cartilages. J Bone Joint Surg Am. 1936; 18 1069-1076
69 Kettelkamp D B, Jacobs A W. Tibiofemoral contact area-determination and implications. J Bone Joint Surg Am. 1972; 54 349-356
70 Mackenzie R, Palmer C R, Lomas D J, Dixon A K. Magnetic resonance imaging of the knee: diagnostic performance studies. Clin Radiol. 1996; 51 251-257
71 De Smet A A, Graf B K. Meniscal tears missed on MR imaging: relationship to meniscal tear patterns and anterior cruciate ligament tears. AJR Am J Roentgenol. 1994; 162 905-911
72 Crues III J V, Mink J, Levy T L, Lotysch M, Stoller D W. Meniscal tears of the knee: accuracy of MR imaging. Radiology. 1987; 164 445-448
73 Duncan J B, Hunter R, Purnell M, Freeman J. Meniscal injuries associated with acute anterior cruciate ligament tears in alpine skiers. Am J Sports Med. 1995; 23 170-172
74 Prince J S, Laor T, Bean J A. MRI of anterior cruciate ligament injuries and associated findings in the pediatric knee: changes with skeletal maturation. AJR Am J Roentgenol. 2005; 185 756-762
75 Rubin D A, Paletta Jr G A. Current concepts and controversies in meniscal imaging. Magn Reson Imaging Clin N Am. 2000; 8 243-270
76 Helms C A. The meniscus: recent advances in MR imaging of the knee. AJR Am J Roentgenol. 2002; 179 1115-1122
77 Dandy D J. The arthroscopic anatomy of symptomatic meniscal lesions. J Bone Joint Surg Br. 1990; 72 628-633
78 Hede A, Larsen E, Sandberg H. The long term outcome of open total and partial meniscectomy related to the quantity and site of the meniscus removed. Int Orthop. 1992; 16 122-125
79 DeHaven K E. Meniscus repair. Am J Sports Med. 1999; 27 242-250
80 Jee W H, McCauley T R, Kim J M et al.. Meniscal tear configurations: categorization with MR imaging. AJR Am J Roentgenol. 2003; 180 93-97
81 Lecas L K, Helms C A, Kosarek F J, Garret W E. Inferiorly displaced flap tears of the medial meniscus: MR appearance and clinical significance. AJR Am J Roentgenol. 2000; 174 161-164
82 Helms C A, Laorr A, Cannon Jr W D. The absent bow tie sign in bucket-handle tears of the menisci in the knee. AJR Am J Roentgenol. 1998; 170 57-61
83 Wright D H, De Smet A A, Norris M. Bucket-handle tears of the medial and lateral menisci of the knee: value of MR imaging in detecting displaced fragments. AJR Am J Roentgenol. 1995; 165 621-625
84 Dorsay T A, Helms C A. Bucket-handle meniscal tears of the knee: sensitivity and specificity of MRI signs. Skeletal Radiol. 2003; 32 266-272
85 Watt A J, Halliday T, Raby N. The value of the absent bow tie sign in MRI of bucket-handle tears. Clin Radiol. 2000; 55 622-626
86 Haramati N, Staron R B, Rubin S et al.. The flipped meniscus sign. Skeletal Radiol. 1993; 22 273-277
87 Cothran Jr R L, Major N M, Helms C A, Higgins L D. MR imaging of meniscal contusion in the knee. AJR Am J Roentgenol. 2001; 177 1189-1192
88 Hayes C W, Brigido M K, Jamadar D A, Propeck T. Mechanism-based pattern approach to classification of complex injuries of the knee depicted at MR imaging. Radiographics. 2000; 20 121S-134
89 Meister B R, Michael S P, Moyer R A, Kelly J D, Schneck C D. Anatomy and kinematics of the lateral collateral ligament of the knee. Am J Sports Med. 2000; 28 869-878
90 LaPrade R F, Ly T V, Wentorf F A, Engebretsen L. The posterolateral attachments of the knee: a qualitative and quantitative morphologic analysis of the fibular collateral ligament, popliteus tendon, popliteofibular ligament, and lateral gastrocnemius tendon. Am J Sports Med. 2003; 31 854-860
91 Recondo J A, Salvador E, Villanua J A et al.. Lateral stabilizing structures of the knee: functional anatomy and injuries assessed with MR imaging. Radiographics. 2000; 20 Spec No S91-S102
92 Shahane S A, Ibbotson C, Strachan R, Bickerstaff D R. The popliteofibular ligament. An anatomical study of the posterolateral corner of the knee. J Bone Joint Surg Br. 1999; 81 636-642
93 Huang G S, Yu J S, Munshi M et al.. Avulsion fracture of the head of the fibula (the “arcuate” sign): MR imaging findings predictive of injuries to the posterolateral ligaments and posterior cruciate ligament. AJR Am J Roentgenol. 2003; 180 381-387
94 Goldman A B, Pavlov H, Rubenstein D. The Segond fracture of the proximal tibia: a small avulsion that reflects major ligamentous damage. AJR Am J Roentgenol. 1988; 151 1163-1167
95 Campos J C, Chung C B, Lektrakul N et al.. Pathogenesis of the Segond fracture: anatomic and MR imaging evidence of an iliotibial tract or anterior oblique band avulsion. Radiology. 2001; 219 381-386
96 Yu J S, Goodwin D, Salonen D et al.. Complete dislocation of the knee: spectrum of associated soft-tissue injuries depicted by MR imaging. AJR Am J Roentgenol. 1995; 164 135-139
97 Hoover N W. Injuries of the popliteal artery associated with fractures and dislocations. Surg Clin North Am. 1961; 41 1099-1112
98 Miller T T, Gladden P, Staron R B, Henry J H, Feldman F. Posterolateral stabilizers of the knee: anatomy and injuries assessed with MR imaging. AJR Am J Roentgenol. 1997; 169 1641-1647
99 Mair S D, Schlegel T F, Gill T J, Hawkins R J, Steadman J R. Incidence and location of bone bruises after acute posterior cruciate ligament injury. Am J Sports Med. 2004; 32 1681-1687
100 Gross M L, Grover J S, Bassett L W, Seeger L L, Finerman G A. Magnetic resonance imaging of the posterior cruciate ligament. Clinical use to improve diagnostic accuracy. Am J Sports Med. 1992; 20 732-737
101 Holmes J C, Pruitt A L, Whalen N J. Iliotibial band syndrome in cyclists. Am J Sports Med. 1993; 21 419-424
102 Murphy B J, Hechtman K S, Uribe J W et al.. Iliotibial band friction syndrome: MR imaging findings. Radiology. 1992; 185 569-571
103 Blazina M E, Kerlan R K, Jobe F W, Carter V S, Carlson G J. Jumper's knee. Orthop Clin North Am. 1973; 4 665-678
104 Ferretti A. Epidemiology of jumper's knee. Sports Med. 1986; 3 289-295
105 Khan K M, Maffulli N, Coleman B D, Cook J L, Taunton J E. Patellar tendinopathy: some aspects of basic science and clinical management. Br J Sports Med. 1998; 32 346-355
106 Johnson D P, Wakeley C J, Watt I. Magnetic resonance imaging of patellar tendonitis. J Bone Joint Surg Br. 1996; 78 452-457
107 Witvrouw E, Bellemans J, Lysens R, Danneels L, Cambier D. Intrinsic risk factors for the development of patellar tendinitis in an athletic population. A two-year prospective study. Am J Sports Med. 2001; 29 190-195
108 Yu J S, Popp J E, Kaeding C C, Lucas J. Correlation of MR imaging and pathologic findings in athletes undergoing surgery for chronic patellar tendinitis. AJR Am J Roentgenol. 1995; 165 115-118
109 Tarsney F F. Catastrophic jumper's knee. A case report. Am J Sports Med. 1981; 9 60-61
110 Ismail A M, Balakrishnan R, Rajakumar M K, Lumpur K. Rupture of patellar ligament after steroid infiltration. Report of a case. J Bone Joint Surg Br. 1969; 51 503-505
111 Halperin N, Oren Y, Hendel D, Nathan N. Semimembranosus tenosynovitis: operative results. Arch Orthop Trauma Surg. 1987; 106 281-284
112 Sonin A H, Fitzgerald S W, Bresler M E et al.. MR imaging appearance of the extensor mechanism of the knee: functional anatomy and injury patterns. Radiographics. 1995; 15 367-382

Eugene McNallyM.D. F.R.C.P. F.R.C.R.

Consultant Musculoskeletal Radiologist, Department of Radiology, Nuffield Orthopaedic Centre

Oxford, United Kingdom