Knee – PCL tear

CASE HISTORY

28-year-old male with pain tightness and limited extension with some swelling since fall and twisting injury 3 weeks ago.

TECHNICAL FACTORS

Long- and short-axis fat- and water-weighted images were performed on a 0.95-Tesla. 

KEY IMAGES

CASE FINDINGS

• Extensor tendons are intact
• Moderate-sized hemarthrosis
• High-grade tear of the proximal anterior cruciate ligament
• Diffuse prepatellar and pretibial contusion versus closed degloving injury (Morel-Lavallee syndrome)
• Minimally depressed comminuted posteromedial tibial plateau fracture with 3mm of depression. Extensive nondisplaced fracture in the posterolateral tibial plateau
• Tibiofibular capsular sprain. Likely sprain of the arcuate ligament
• Grade 2 sprain with interstitial PCL tear
• Contusion in the posterior root of the lateral meniscus. No traumatic meniscal tears are demonstrated
• Grade 1 to 2 sprain of the tibial collateral ligament. Lateral collateral complex low-grade sprain noted. Popliteus myotendinous junction sprain. Tendon is intact
• Popliteal neurovascular structures are unremarkable. Chondral contusion demonstrated in the lateral femoral condyle
• Low-grade patellofemoral chondromalacia
• Tiny peripheral vertical meniscus red red zone body microtear. Possible knee subluxation.

CASE CONCLUSION

• Pivot-shift injury with high-grade ACL tear nondisplaced fracture of the posterolateral tibial plateau grade 2 tibial collateral ligament sprain chondral contusion laterally and contusion of the posterior root of the lateral meniscus without traumatic tear. Interstitial PCL tear. Diffuse capsular sprain. 
• Contrecoup injury with mildly depressed fracture of the posteromedial tibial plateau and low-grade fibular collateral sprain.
• Grade 2 sprain with partial tear of the posterior cruciate ligament.
• Posterolateral corner injury with popliteus myotendinous junction sprain (tendon otherwise intact). Tibiofibular capsular and likely arcuate ligament sprain. 
• Diffuse swelling in the anterior superficial soft tissues as described.
• Tiny peripheral vertical meniscus red red zone body microtear. Possible knee subluxation?