📌 MRI Findings in Grade 3 Superficial MCL Injury
- Complete discontinuity of the proximal superficial MCL and adjacent soft tissue edema, indicating a full-thickness tear.
📌 Involvement of MPFL in MCL Injuries
- Injuries of the superficial MCL can propagate anteriorly to involve the anterior MPFL.
- The MPFL merges with the fibers of the MCL at the epicondyle.
- The MPFL appears abnormal in most patients with clinically and MRI-documented cases of superficial MCL sprains or tears at or above the knee joint line.
✅ Clinical Relevance of MPFL Abnormalities
- The femoral third of the oblique decussation component of the MPFL, which arises from the anterior margin of the upper superficial MCL, appears abnormal in approximately 90% of cases involving superficial MCL injuries.
- Despite these MPFL abnormalities, there is no evidence of concurrent lateral patellar dislocation on the initial MRI scans.
✅ MPFL Anatomy
- The MPFL consists of a thinner, more superior transverse component attaching to the medial femoral condyle and a broader, more inferior oblique decussation component arising from the upper segment of the superficial MCL.
Skeletal Radiol. 2022 Jul;51(7):1381-1389.
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