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📌 Diagnosing Chronic PCL Tears
1️⃣ : Understanding PCL Appearance on MRI
- Chronic tears of the Posterior Cruciate Ligament (PCL) often present subtle signs that can be challenging to detect on MRI.
- Studies indicate that nearly 28% of chronic PCL injuries might appear almost normal, while another 44% may demonstrate continuity but with noticeable residual morphologic deformities.
2️⃣: The Role of Proton Density Imaging
- Proton density imaging, particularly with fat suppression, is crucial for highlighting subtle pathological changes within the PCL. T
- his technique often reveals increased intraligamentous signal intensity that might not be evident on T2-weighted images.
- For instance, in a case where the PCL diameter and contour appeared normal on T2WI, the proton density sequence unveiled significant abnormalities leading to a correct diagnosis of
3️⃣: The Value of Stress Radiography
- In cases where MRI results are equivocal, stress radiographs provide an objective method to evaluate the structural integrity of the PCL.
- By quantifying the extent of posterior tibial translation, this technique helps distinguish between partial and complete tears. Measurements show that less than 8mm of translation usually indicates a partial tear, 8-12mm a complete tear, and more than 12mm typically suggests a combined complete tear involving the posterolateral corner.
Magn Reson Imaging Clin N Am 22 (2014) 557–580
Magn Reson Imaging Clin N Am. 2022 May;30(2):261-275
AJR Am J Roentgenol. 2008 Oct;191(4):1031
Am J Sports Med. 2015 Dec;43(12):3077-92
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| (Fig 2-E.23) Chronic Complete Tear of the PCL - Part 1 (2) | 2024.04.28 |
| (Fig 2-E.22) Posterior Tibial Translation (0) | 2024.04.28 |
| (Fig 2-E.21) Radiographic Assessment of Posterior Knee Laxity (0) | 2024.04.27 |