1 Kacey Court, Suite 100, Mechanicsburg, Pa, 17055. In this study, the time gap between injury and doing MRI was not considered. bone contusion) can give clues for the mechanism and associated injuries. <> Sanders classified bone marrow contusions in five different patterns as: Clip injury, Pivot shift injury, Dashboard injury, Hyperextension injury, and Lateral patellar dislocation [8]. Federal government websites often end in .gov or .mil. -. Arch Orthop Trauma Surg. PubMed Grade 1 refers to the uniform-ly low normal meniscal signal, grade 2 de-scribes increased signal within the meniscus . Boks SS, Vroegindeweij D, Koes BW, Hunink MG, Bierma-Zeinstra SM. PubMed The most common sites of bone bruising were the anteromedial tibial plateau (48%) and anterolateral tibial plateau (44%). Felt a "popping" sensation after landing on a straightened knee. Pivot shift injury depending on location and type/mode of injury. and kissing contusions of the lat-eral femoral condyle and medial tibial pla . The authors have no relevant financial or non-financial interests to disclose. Pivot shift injury in different location and its correlation with sports related injury and other type/mode of injury. This is a preview of subscription content, access via your institution. Lateral-compartment bone contusions in adolescents with intact anterior cruciate ligaments. -, Am J Sports Med. Objective: To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint. Increase in interstitial water content and hyperperfusion contributes to bone marrow oedema formation. A total of 1000 patients were enrolled in this study, including 500 patients with ACL injuries who assigned to experimental group and 500 patients with meniscal tear (MT) who allocated to control group. A prospective study of the association between bone contusion and intra-articular injuries associated with acute anterior cruciate ligament tear. Bone marrow oedema is usually most prominent in the lateral femoral condyle secondary to the direct blow, whereas a second smaller area of oedema in the medial femoral condyle secondary to avulsive stress to the MCL. 255 MRI examinations in athletes with acutely injured knees (197 men; 58 women; mean age 24.2 years) were reviewed by two independent examiners; 219 MRIs were done within the first month after the injury and 36 within two to four months. Google Scholar, Bernard M, Pappas E, Georgoulis A, Haschemi A, Scheffler S, Becker R (2020) Risk of overconstraining femorotibial rotation after anatomical ACL reconstruction using bone patella tendon bone autograft. Epub 2013 Jun 6. Arndt WA, Traux AL, Baranett FM, Simmon GE, Brown DC. 2022 Oct;30(10):3508-3514. doi: 10.1007/s00167-022-06970-z. Magnetic resonance imaging of bone bruising in the acutely injured kneeshort-term outcome. uuid:a4a67e17-1dd1-11b2-0a00-340827bd7200 1996;330:13342. steve stricker wrist lock; what channel are the st louis cardinals playing on today +(91)-9821210096 | paula deen meatloaf with brown gravy. Learn more about Institutional subscriptions. In total 200 cases, bone marrow contusion was noted in 138 cases (69%) and absent contusion in 62 cases (31%). If the knee is exposed to forces beyond its physiologic range, risk of injury to bone or soft tissue structures increases. Mild high signal of the distal semimembranosus insertion, however, the remaining posteromedial corner structures appear uninjured. A deeper notch often indicates a more complex knee injury. HHS Vulnerability Disclosure, Help In this study, inclusion criteria included history of knee injury within 6 weeks or suspected ACL injury [12]. 2011;133:011012. government site. Herbst E, Hoser C, Tecklenburg K, Filipovic M, Dallapozza C, Herbort M, et al. https://doi.org/10.1007/s00256-017-2754-y, https://doi.org/10.1016/j.arthro.2016.03.015. The LFNS and KC have strong clinical significance in the diagnosis of ACL injuries. Epub 2022 May 3. 8600 Rockville Pike Contusions of both surfaces of the joint are known as kissing contusions.Objective: To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint.Methods: 255 MRI examinations in athletes with acutely injured knees (197 men; 58 women; Related Papers Our study only involves the image information of patients. government site. The spectrum of damage includes stretching, partial tearing, and complete rupture [4]. 31 0 obj Deangelis JP, Spindler KP. Bone marrow contusion was noted in 71 cases out of 255 cases (27.8%). Most common type / mode of injury in patients with unclassified pattern in fall from bike (3 cases) followed by hit by car/ motor vehicle (2 cases) and injury while lifting heavy weight in 1 case [Table/Fig-13]. CAS Orthop J Sports Med. Mandalia V, Henson JH. sharing sensitive information, make sure youre on a federal Google Scholar, Pao DG (2001) The lateral femoral notch sign. Hayes CW, Brigido MK, Jamadar DA, Propeck Tim. Kung JW, Yablon CM, Eisenberg RL. PDFS Coronal: Bone marrow oedema at Medial femoral condyle and proximal tibia. Correlation between various pattern of bone marrow oedema and type/mode of injury. Shi H, Ding L, Jiang Y, Zhang H, Ren S, Hu X, Liu Z, Huang H, Ao Y. Orthop J Sports Med. 2000;20 Spec No (suppl_1): S135-51. Notch syndrome refers to the enlarged and deepened lateral femoral condyle. 2014 Feb;44(2):281-93. doi: 10.1007/s40279-013-0116-z. PubMed Patients were scanned using 1.5 Tesla Seimens Avanto (Tim + Dot) with Tx/Rx 15 channel knee coil # Tim. Radiol Med. Conclusions: government site. The most common symptom of a knee contusion is pain. The site is secure. 2023 Springer Nature Switzerland AG. Minor focus of edema in the anterior aspect of the lateral femoral condyle. On MRI these injuries appears as ill defined, subchondral, reticulated or stellate region of low signal intensity on T1W and high signal intensity on T2W images [6]. Mandalia V, Fogg AJB, Chari R, Murray J, Beale A, Henson JHL. 6 Resident, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. Arch Orthop Trauma Surg 140(12):20132020, Article FOIA Matrix in various sequences were listed as : T1 Saggital 307 x 384, T2 Axial - 314 x 448, T2 Saggital 314 x 448, PD Saggital 307 x 384, PD Coronal 355 x 384, PDFS Saggital 288 x 384, PDFS Coronal 311 x 384, MEDIC Axial 240 x 320. The saggital plane was primarily used to evaluate the bone marrow oedema which was confirmed on coronal images. 5 out of 8 patients with a 'double sulcus' on the lateral radiograph had ACL injury. Presence of contusion may also effect management of knee injuries often requiring prolonged rest even in absence of surgical correctible lesion and establishing diagnosis of bone marrow contusion may obviate further costly work up like arthroscopy. Knee Surg Sports Traumatol Arthrosc 23(8):22502258, Hoffelner T, Pichler I, Moroder P et al (2015) Segmentation of the lateral femoral notch sign with MRI using a new measurement technique. Semin Ultrasound CT MR. 1994 Oct;15(5):396-409. doi: 10.1016/s0887-2171(05)80006-x. Bone marrow oedema on T2 weighted magnetic resonance (MR) images is recognized as an ill-defined hyperintensity in the bone marrow where standard radiographs showed nonspecific osteopenia or normal findings [3]. In tensile load, on the other hand, bones pull apart leading to distraction across the joint and traction on stabilizing structures. 2 cases (50%) are hyperextension injury with kissing contusion at anterior aspect of proximal tibia and distal femur caused due to hit by car in RTA. Bone marrow oedema of the knee may cause substantial clinical entities, as they cause acute pain and functional loss in the joint. -, Acta Orthop Scand. Our results therefore suggest that kissing contusions are more common following knee hyperextension than in other forms of knee injury and predominantly affect the medial side. Type / Mode of injury in Clip injury pattern. Horizontal Rafting Plate for Treatment of the Tibial Plateau Fracture. Popular works include The appearance of kissing contusion in the acutely injured knee in the athletes, Role of Magnetic Resonance Imaging in Study of the Patellofemoral Joint Morphological Abnormalities Predisposing to Patellar Instability and more. 1993 Mar-Apr;21(2):220-3 endobj Arthroscopy. The https:// ensures that you are connecting to the Compressive load causes bone marrow contusion and, if sufficient in magnitude, depressed cortical fracture. Objective: To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint. PubMed Central Analysis of bone marrow oedema was done by a single observer based on MRI [9], its patterns were studied and possible type/mode of injury was determined before elucidating the history from the patient. 5 out of 8 patients with a double sulcus on the lateral radiograph had ACL injury. Patel SA, Hageman J, Quatman CE, Wordeman SC, Hewett TE. Acrobat Distiller 5.0.5 (Windows) [11] Anterior displacement of tibia refers to increased distance from the posterior cortex of the lateral tibial plateau to the posterior cortex of the femur. doi: 10.2106/JBJS.OA.21.00069. [1] References [ edit] ^ Terzidis, I. P. (October 2004). <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/TrimBox[57.25999 58.11 666.34 848.69299]/Type/Page>> Hyperextension results in the "kissing" contusion pattern involving the anterior aspect of the proximal tibia and distal femur. The bone bruise or bone contusion are commonly used to define an occult bone alteration oedematous haemorrhagic due to trabecular microfractures as a result of a direct blow to the bone, application of compressive forces on contiguous bones with a consequent impact mechanism, and the action of a torsional force, and to stresses by traction on the subchondral bone by insertion of the ligament, tendon or capsular as occurs in traumatic avulsion [1]. Radiographics. Conventional radiograph evaluation of skeleton following trauma divides injury into presence or absence of fracture. Bisson LJ, Kluczynski MA, Hagstrom LS, Marzo JM. Study was conducted between May 2014 to September 2015 with sample size of 200 patients, after taking the institutional ethical clearance. Hong CK, Lin YJ, Cheng TA, Chang CH, Hsu KL, Kuan FC, Su WR. Bone contusion patterns of the knee at MR imaging: footprint of the mechanism of injury. MR imaging performed in two patients with kissing contusions showed persistence of the tibial lesions. You can use Radiopaedia cases in a variety of ways to help you learn and teach. Kapelov SR, Teresi LM, Bradley WG, Bucciarelli NR, Murakami DM, Mullin WJ, et al. 3 Professor, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. PDFS Saggital: Bone marrow oedema at Medial femoral and Medial tibial condyle in Hyperextension injury. Rangger C, Klestil T, Kathrein A, Indester A, Hamid L. Influence of magnetic resonance imaging on indications for arthroscopy of the knee. Bone marrow oedema may also be rarely seen at adductor tubercle of the medial femoral condyle due to avulsion injury of the medial patellofemoral ligament. The clip injury results in a prominent area of edema involving the lateral femoral condyle and a smaller area of edema involving the medial femoral condyle. Contusion in medial femoral condyle occurs secondary to the avulsion to medial collateral ligament from site of attachment at medial femoral condyle [8]. In impaction, the compressive force directly strikes cortical bone and is dissipated into trabecular bone [4]. CAS Pivot shift pattern is most common contusion pattern and the most common type/mode of injury is sports related injury. 5 0 obj Texas Health Care Imaging has been registered with the National Provider Identifier database since May 25, 2021 and its NPI number is 1053986786 (certified on 05/25/2021). Follow-up of occult bone lesions detected at MR imaging: systematic review. PMC 1996;198:2058. Contusions of both surfaces of the knee joint are known as kissing contusions. Table showing Type/Mode of injury in pivot shift injury. Bone bruise patterns in knee injuries: where are they found? PubMed In six cases (4.3%) no pattern of bone marrow contusion could be explained and was categorized as unclassified pattern [Table/Fig-6]. A load that is too low to cause cortical fracture may be sufficient to disrupt trabecular bone and produce marrow contusion. The Predicted Position of the Knee Near the Time of ACL Rupture Is Similar Between 2 Commonly Observed Patterns of Bone Bruising on MRI. Furthermore, it is anterior tibial oedema rather than the presence of kissing lesions than predicts cruciate ligament injury (OR = 10.5, p = 0.02). Other structures are injured less frequently and have weaker associations with bone bruise distribution. 2019 Nov;27(11):3633-3637. doi: 10.1007/s00167-019-05490-7. severe contusions may cause the knee to give out or lock. This case demonstrates a hyperextension knee injury consisting of partial posterior cruciate ligament tear proximal tibia epiphysis bone contusion and minor "kissing contusion" of the lateral femoral condyle posterior soft tissue injuries involving the knee joint capsule, fibular attachment of soleus and distal semimembranosus tendon Traumatic mechanisms are sometimes too complex or poorly understood which cannot be comprehend [4]. Bone bruising; Knee hyperextension; MRI. NAME, ADDRESS, E-MAIL ID OF THE CORRESPONDING AUTHOR: Dr. Ashish Garg, A-4, Ashok Nagar, Mandoli Road, Shahdara, Delhi-110093, India. LXC designed the study and was responsible for the paper. 1999;211:74753. Bone contusion patterns of the knee at MR imaging: footprint of the mechanism of injury. PubMed 2011;93:15108. Am J Sports Med. 2010 Dec;38(12):2502-8. doi: 10.1177/0363546510376232. 36 0 obj A thorough understanding of knee injury patterns and their mechanisms may help in achieving more accurate assessment of injuries. 21033-6-01). Ryu KN, Jin W, Ko YT, Yoon Y, Oh JH, Park YK, et al. 1. 2013 Aug;41(8):1801-7. doi: 10.1177/0363546513490649. {"url":"/signup-modal-props.json?lang=us"}, Knipe H, Yap J, Al Kabbani A, et al. National Library of Medicine Br J Sports Med 42(6):394412, Saxena A, Ray B, Rajagopal K, DSouza A, Pyrtuh S (2012) Morphometry and magnetic resonance imaging of anterior cruciate ligament and measurement of secondary signs of anterior cruciate ligament tear. 1999 Jun;211(3):747-53 PubMed Rangger C, Kathrein A, Freund MC, Klestil T, Kreczy A. Br J Sports Med. An official website of the United States government. https://doi.org/10.1007/s00256-017-2754-y, DOI: https://doi.org/10.1007/s00256-017-2754-y. 2002;10:96101. 1996 Sep;(330):133-42 Bone marrow contusion is transient dislocation of patella noted in anterior aspect of lateral femoral condyle and inferiomedial aspect of patella in all the cases (100 %). Right knee injury was noted in 87 cases (63%) and left knee in 51 cases (37%). 10 0 obj PDFS Saggital: Bone marrow oedema at Lateral femoral condyle in Clip injury pattern. The knee is a major weight bearing joint that provides mobility and stability during physical activity as well as balance while standing. Home; Service. endobj 99 0 obj Article The site is secure. and transmitted securely. 2000;24:37180. FOIA It also was revealed that when the optimal cut-off point of LFNS was 0.72mm (area under the curve (AUC)=81%), the values of specificity and sensitivity were 67% and 84%, respectively. Bone contusion and associated meniscal and medial collateral ligament injury in patients with anterior cruciate ligament rupture. <>stream Pattern of marrow oedema as per classification. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Sahoo K, Garg A, Saha P, Dodia JV, Raj VR, Bhairagond SJ. Am J Sports Med. N Z Med J. Computed Tomography & Magnetic Resonance Imaging Of The Whole Body. The presence of a double sulcus showed significant association with anteromedial kissing contusions (OR = 7.8, p = 0.03). Out of 200 patients, 32 were women (16%) and 168 men (84%). Patterns of bone bruise in knee injury. Radiographics : a Review Publication of the Radiological Society of North America, Inc , 01 Oct 2000, 20 Spec No: S135-51. Biomechanical Approach to MRI of Acute Knee Injuries. Orthopedic radiology Philadelphia, Pa: Saunders, 1986; 502, 511. Other soft tissue injuries include: ACL (100%), PCL (7.6%), Medial meniscus (89.7%), Lateral meniscus (23.1%), LCL (7.6%). The diagnostic outcome of LFNS was not in agreement with that of KC, as there was a poor coincidence according to the Kappa coefficient (Kappa=0.155<0.4, P=0.035). Radiology 193(3):835840, Grimberg A, Shirazian H, Torshizy H, Smitaman E, Chang EY, Resnick DL (2015) Deep lateral notch sign and double notch sign in complete tears of the anterior cruciate ligament: MR imaging evaluation. This article about a disease of musculoskeletal and connective tissue is a stub. Unclassified injury pattern in 6 cases with type /mode of injury and location of bone marrow contusion. Department of Radiology, Wilford Hall Medical Center, 759th MDTS/MTRD, 2200 Bergquist Dr, Ste 1, Lackland AFB, TX 78236-5300, USA. Patient was placed in supine position with knee externally rotated 10-20 degree 21. PLT: Posterloateral tibial plateau, LF: Lateral femoral condyle, MT: Medial tibial condyle, MF: Medial femoral condyle. Posterior tibial bone bruising associated with posterior-medial meniscal tear in patients with acute anterior cruciate ligament injury. Associated Soft tissue injuries include ACL and medial meniscus [8]. Objective: To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint. Grade II ACL tears represent intraligamentous injury and an increase in ligament length. bone bruises on magnetic resonance imaging evaluation of anterior cruciate ligament injuries. Kapelov et al., conducted a study to demonstrate that T2 weighted fast spin echo (FSE) images with spectroscopic fat saturation (FS- FSE) increase conspicuity between marrow contusion and normal marrow in post traumatic knee and found bone marrow contusion in 21 out of 76 cases (27.6%) which is less than our study (69%) [11]. Perin B, Nardacchione R, Bonaga S, Angelini F, Girotto A, Giovagnoni A, et al. 2011;68:7626. 1993;189:9014. 2023 Feb;19(1):107-112. doi: 10.1177/15563316221092320. Boks SS, Vroegindeweij D, Koes BW, Bernsen RM, Hunink MG, Bierma-Zeinstra SM. Kirsch MD, Fitzgerald SW, Friedman H, Rogers LF. Am J Sports Med. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. The authors declare that they have no conflict of interest. no financial relationships to ineligible companies to disclose. Diagnostic value of the lateral femoral notch sign and kissing contusion in patients with anterior cruciate ligament injuries: a case-control study. The pattern of bone bruise in knee injuries (a.k.a. Over 2600 credentialed providers acrosstheUS. Objective: On MR images, trabecular contusion has the appearance of bone marrow oedema. 2000;28:6637. The .gov means its official. Fornalski S, McGarry MH, Csintalan RP, Fithian DC, Lee TQ. Transient patellar dislocation is a common sports-related injury in young adults. In addition to trauma, marrow oedema can be seen in a broad spectrum of entities, including infection, transient osteoporosis of the hip bone marrow, and neoplasm demonstrates relatively hyperintense T2 and hypointense T1 signal, but the clinical history and location of injury typically allows the correct diagnosis to be made [2]. Arch Orthop Trauma Surg 143, 927934 (2023). Tensile load can cause ligament and tendon tears as well as avulsion fracture. 2023 Jan;51(1):58-65. doi: 10.1177/03635465221131551. 2006;238:85362. 2004;32:16817. - 103.57.222.214. (2008) ISBN:0323076211. 4. MRI Introduction Anterior cruciate ligament (ACL) injuries are among the most common sports injuries. Language links are at the top of the page across from the title. Waldn M, Krosshaug T, Bjrneboe J, Andersen TE, Faul O, Hgglund M. Three distinct mechanisms predominate in non-contact anterior cruciate ligament injuries in male professional football players: a systematic video analysis of 39 cases. Background: Bone contusions are often identified at magnetic resonance imaging (MRI) in the acutely injured knee. Careers, Unable to load your collection due to an error. Kessler R, Campbell S, Wong D, Mansfield LB.
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kissing contusion knee radiology