28-year-old male football player who heard a pop while making a cut

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Case History

Right knee pain and swelling; was playing football last Sunday and while making a cut felt something in his right knee. No prior surgery.

Technical Factors

AX T2 COR WSE SAG WSE SAG T1.

Case Findings

Lateral retinaculum MPFL and patellar alignment are normal. No high-grade chondromalacia of the patellar or trochlear cartilage.
Quadriceps tendon patellar tendon and flexor mechanism are unremarkable.
Complete midbody tear of the ACL with anterior tibial translation. PCL is intact. Grade 3a MCL sprain. Posterolateral corner imjury with tear of the popliteal fibular ligament posterolateral and posteromedial meniscocapsular rupture with hemorrhage lateral meniscopopliteal complex tear and partial tear of the popliteus tendon at the origin. Oblique tear of the posterior body of the medial meniscus measuring 2-2.5cm in length. Oblique tear of the posterior corner of the lateral meniscus measuring 2.5cm in length.
3-4+ hemarthrosis. Chondral body at the base of the PCL measuring 6 x 5 x 8mm best seen on series 80801 image 12.
Subchondral depressed impaction fracture of the lateral femoral condyle at the terminal sulcus with reactive osteoedema. Displaced chip fracture of the posterolateral tibial plateau with active osteoedema. No high-grade chondromalacia of the medial or lateral compartments.
Musculature and marrow signal are normal. No posterior soft tissue masses or Baker’s cyst. The neurovascular bundle is intact.

Case Conclusion

Violent Pivot shift injury with complete midbody tear of the ACL massive posterolateral corner injury meniscocapsular rupture with hemorrhage postero- medial andpostero- lateral and 3-4+ hemarthrosis. Associated depressed subchondral impaction fracture of the lateral femoral condyle and displaced chip fracture of the posterior lateral tibial plateau.
Oblique posterolateral corner ligament lateral meniscus tear measuring 2.5cm in length.
Oblique 2-2.5cm tear of the posterior body of the medial meniscus.
Chondral body at the base of the PCL.

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