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Anterior Cruciate Ligament on MRI: Coronal View

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Knee anatomy.

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Cruciates.

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Anterior cruciate coronal projection on MRI,

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T2 MRI all the way in the back, posteriorly,

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where the insertion of the PCL in the deep posterior

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tibial notch below the tibial plateau is seen.

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But where is our ACL,

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which is a little bit thinner than the PCL?

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Well, it's starting to take off right there along the

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medial wall of the lateral femoral condyle.

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The next cut should show it to us.

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This is posterior. This is our cut.

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This is anterior. There's your ACL.

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There's your over-the-top position of your ACL.

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Let's keep following it forward.

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It should look like a water slide.

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It should be straight. The bundles,

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the anteromedial and posterolateral bundle.

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Posterior lateral being a little more substantive,

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should be parallel to one another.

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I'll allow a little bit of waviness to it as we age.

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The cruciate is also a little grayer as we age,

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but let's keep following it down.

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There's the anteromedial and posterolateral bundle.

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Keep going.

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Now they're starting to attach to the space

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between and anterior to the tibial spines.

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Now we're in front of the tibial spines,

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and the attachment is apparent.

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The coronal projection is your best projection for diagnosing

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tibial evulsion spine injuries to the ACL,

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but also distal ACL tears

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when there is a question in the sagittal projection.

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Let's keep going.

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Seeing the attachment on the surface of the tibia.

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And we said earlier that the ACL lies between the menisci.

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It certainly does.

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There's the anterior horn of the lateral meniscus.

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There's our attachment of the ACL.

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We also said earlier that there are some fibers from

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the ACL that go over towards the lateral meniscus.

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And there's one of them right there.

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This is a little harder to appreciate

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in the coronal projection than it was displayed in the sagittal projection.

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ACL in the coronal projection: straight

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water slide, pretty good for seeing the femoral component.

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Excellent for seeing the tibial component.

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Excellent for seeing accompanying tibial spine

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evulsions with injuries to the distal ACL.

Report

Description

Faculty

Stephen J Pomeranz, MD

Chief Medical Officer, ProScan Imaging. Founder, MRI Online

ProScan Imaging

Tags

Trauma

Musculoskeletal (MSK)

MRI

Knee

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