Anterior Cruciate Ligament on MRI: Axial View
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Knee anatomy.
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Cruciates ACL axial projection T2-weighted image.
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We've got our straight,
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but thinner than the PCL anterior cruciate ligament and
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we can follow it back to its over the top position,
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nice and straight, and black, and parallel to the inner edge
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or medial aspect of the lateral femoral condyle.
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This is how you diagnose
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a proximal anterior cruciate ligament tear.
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For if there is interruption at any point in this course as
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we follow it down or the fibers are wavy or displaced,
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you should be worried about ACL pathology of some kind,
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depending upon the morphology.
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Now, it is said that the posteromedial bundle, which is right here,
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I think I'll draw over it,
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it's the posteromedial bundle right there.
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And here's the anterolateral bundle right there.
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And then anteriorly, they're a little inseparable.
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This bundle is said to be a little bit
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grayer than the anterolateral bundle.
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Let's keep following them down to their fossa
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that sits just in front of the eminence of the tibial spines.
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There's the eminence of the tibial spines.
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Here is the insert region of the anterior cruciate ligament.
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And then in front of this,
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you'll see wispy and sometimes thicker linear structures that
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consist of either the transverse ligament of Winslow or the
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ligamentum mucosum, which attaches to the infrapatellar plica.
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Let's back it up a little bit and follow it back,
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nice and straight. Back to the inner wall,
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the lateral femoral condyle.
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And do not forget that the anterior cruciate ligament
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not seen so well in this projection,
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gives a few contributions to the anterolateral meniscus.
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Let's have a look at the coronal projection if you have time.
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
ProScan Imaging
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