28-year-old male with pain tightness and limited extension

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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.

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?

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