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✅ Knee MRI Mastery/Chap 1. Meniscus

(Fig 1-B.21) Double ACL Sign Bucket-Handle Tear (Lateral meniscus)

by MSK MRI 2024. 2. 3.

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Double ACL Sign:

  • Occasionally, a bucket-handle tear of the lateral meniscus can present with what's known as the "Double ACL Sign."
  • This sign occurs when the torn fragment is positioned just posterior to the anterior cruciate ligament (ACL).
  • It's important to note that this sign is specific to lateral meniscal tears and is not seen in medial bucket-handle tears, where the "Double PCL Sign" is more indicative.

Fragment in Notch Sign:

  • This sign occurs when the displaced meniscal fragment ends up in the intercondylar notch but isn't in the same sagittal plane as the posterior cruciate ligament (PCL).
  • This sign is more commonly associated with lateral bucket-handle tears.
  • However, it's crucial to remember that while these signs are sensitive and helpful, they are not entirely specific to bucket-handle tears.

It's worth noting that other conditions, such as flap tears that are displaced toward the intercondylar notch, can also exhibit a "Fragment in Notch Sign." Therefore, seeing this sign should not automatically lead to the assumption that the meniscal tear is a bucket-handle tear.

 

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