kissing contusion knee radiology

Kim SY, Spritzer CE, Utturkar GM, Toth AP, Garrett WE, DeFrate LE. The LFNS and KC have strong clinical significance in the diagnosis of ACL injuries. - 134.209.62.117. Am J Sports Med. BMC Musculoskelet Disord 16:217, Article Unable to process the form. Application of biomechanical approach in MR interpretation helps in effortless assessment of osseous contusion and ligament rupture and mark delicate but significant abnormalities. MRI Introduction Anterior cruciate ligament (ACL) injuries are among the most common sports injuries. Bethesda, MD 20894, Web Policies Br J Sports Med 42(6):394412, Saxena A, Ray B, Rajagopal K, DSouza A, Pyrtuh S (2012) Morphometry and magnetic resonance imaging of anterior cruciate ligament and measurement of secondary signs of anterior cruciate ligament tear. Shi H, Ding L, Jiang Y, Zhang H, Ren S, Hu X, Liu Z, Huang H, Ao Y. Orthop J Sports Med. If the knee is exposed to forces beyond its physiologic range, risk of injury to bone or soft tissue structures increases. Part of Springer Nature. The presence of a double sulcus showed significant association with anteromedial kissing contusions (OR=7.8, p=0.03). 35 0 obj Compression and tension are two basic loads that commonly act on the knee [4]. knees against dashboard in motor vehicle collision, or fall onto flexed knee), contusion pattern:anterior tibia +/- posterior patella, contusion pattern: lateral femoral condyle and lateral tibial plateau +/- medial femoral condyle from medial collateral ligament (MCL) avulsive stress, direct force to anterior tibia with foot planted, contusion pattern: "kissing contusions" of anterior tibial plateau and anterior femoral condyle, contusion pattern: anterolateral lateral femoral condyle and inferomedial patella, associated with medial patellar retinaculum +/-. volume47,pages 173179 (2018)Cite this article. 2023 Jan;51(1):58-65. doi: 10.1177/03635465221131551. 2016. https://doi.org/10.1016/j.arthro.2016.03.015. Following knee hyperextension, bone bruising patterns may be associated with cruciate ligament injury. After knee injury, bone marrow oedema is frequently subchondral in location and may be associated with either trabecular or cortically based lines [4]. Disclaimer. Am J Sports Med. Radiology 193(3):835840, Grimberg A, Shirazian H, Torshizy H, Smitaman E, Chang EY, Resnick DL (2015) Deep lateral notch sign and double notch sign in complete tears of the anterior cruciate ligament: MR imaging evaluation. Am J Sports Med. KIS Imaging is the nations largest direct contracting imaging network with over 2,600 providers covering all major imaging needs: MRI, CT and PET. A prospective study of the association between bone contusion and intra-articular injuries associated with acute anterior cruciate ligament tear. PLT: Posterloateral tibial plateau, LF: Lateral femoral condyle, MT: Medial tibial condyle, MF: Medial femoral condyle. Mechanism of traumatic knee injuries and MR findings. 2000;28:6637. Sanders classified bone marrow contusions in five different patterns as: Clip injury, Pivot shift injury, Dashboard injury, Hyperextension injury, and Lateral patellar dislocation [8]. Knee Surg Sports Traumatol Arthrosc 27(2):659664, Miller LS, Yu JS (2010) Radiographic indicators of acute ligament injuries of the knee: a mechanistic approach. Home; Service. It is a rare (6.3% in this series) but significant injury, often associated with ligamentous or menisceal tears. 2022 Dec;30(12):1647-1657. doi: 10.1016/j.joca.2022.08.006. Ciuffreda P, Lelario M, Milillo P, Vinci R, et al. Ryu KN, Jin W, Ko YT, Yoon Y, Oh JH, Park YK, et al. The bone bruise or bone contusion are commonly used to define an occult bone alteration oedematous haemorrhagic due to trabecular microfractures as a result of a direct blow to the bone, application of compressive forces on contiguous bones with a consequent impact mechanism, and the action of a torsional force, and to stresses by traction on the subchondral bone by insertion of the ligament, tendon or capsular as occurs in traumatic avulsion [1]. It can also damage interposed soft tissues, most commonly the articular cartilage and meniscus. The presence of a double sulcus showed significant association with anteromedial kissing contusions (OR = 7.8, p = 0.03). Plain radiograph of knee was done in all patients and they were scanned using 1.5 Tesla Seimens Avanto (Tim + Dot) with Tx/Rx 15 channel knee coil # Tim. 2011;68:7626. Results are comparable to the study conducted by Kaplan et al., in which bone marrow contusion at posterior lip of medial tibial condyle was seen in 25 out of 215 cases (11.6%) and contusion in lateral compartment was noted in 24 out of 25 cases (96%) and contusion at medial femoral condyle was seen in 5 in 25 cases (20%) [7]. School of Clinical Medicine, Tsinghua University, Beijing, China, Peking University Third Hospital, Beijing, China, Beijing Tsinghua Changgung Hospital Affiliated To Tsinghua University, Beijing, China, Heng Gong,Xiaofei Zhang,Ligong Fu&Lianxu Chen, You can also search for this author in <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/TrimBox[57.25999 58.11 666.34 848.69299]/Type/Page>> Br J Sports Med. Would you like email updates of new search results? By applying a biomechanical approach in MR interpretation, it is possible to detect lesions like ligament rupture and osseous contusion, to predict subtle but it might overlook important abnormalities. the contents by NLM or the National Institutes of Health. Fill out the form below and a representative will be in touch. Bookshelf Pivot shift pattern is most common contusion pattern and the most common type/mode of sports related injury. Orthop J Sports Med. 2016;10(4):TC0611. Magnetic resonance imaging of bone bruising in the acutely injured kneeshort-term outcome. Contusions of both surfaces of the joint are known as kissing contusions.Objective: To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint.Methods: 255 MRI examinations in athletes with acutely injured knees (197 men; 58 women; Related Papers of knee injury in pediatric patients. These lesions also referred to as bone bruises, are presumably the result of microfracture of the medullar trabecula [5]. Results: The authors declare that they have no conflict of interest. Reference article, Radiopaedia.org (Accessed on 02 May 2023) https://doi.org/10.53347/rID-43268, Case 3: pivot-shift injury with ACL and meniscal tears, Case 4: pivot-shift injury with impacted tibial plateau fracture, see full revision history and disclosures, doi:10.1148/radiographics.20.suppl_1.g00oc19s135, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, Ahlback classification system in assessing osteoarthritis of the knee joint, Kellgren and Lawrence system for classification of osteoarthritis, anterior cruciate ligament mucoid degeneration, MRI grading system for meniscal signal intensity, Pattern of bone contusion in knee injuries, valgus stress to flexed and externally rotated knee, contusion pattern:posterolateral tibial plateau and mid part of lateral femoral condyle, anterior force to tibia in a flexed knee (e.g. While the knee is in a state of flexion, twisting motion of the knee can lead to transient dislocation of knee. A cross-sectional study was done on all patients referred to Krishna Hospital, Karad for MRI knee with history of recent (< 6 weeks) knee injury. official website and that any information you provide is encrypted In this study hyperextension injury noted in 4 cases in 138 cases (2.9%). Furthermore, it is anterior tibial oedema rather than the presence of kissing lesions than predicts cruciate ligament injury (OR = 10.5, p = 0.02). Calvo-Gurry M, Hurley ET, Withers D, Vioreanu M, Moran R. Knee Surg Sports Traumatol Arthrosc. PDFS Coronal: Bone marrow oedema at Medial femoral condyle and proximal tibia. 2015;49:145260. <>stream No fractures were present on x ray. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. On 1.5 T, knee joint was examined in Saggital (T1, T2, PD, PDFS), Coronal (T2/ PDFS), Axial (T2, Medic) sequences. Bone marrow oedema may also show delayed enhancement following administration of gadolinium DTPA. To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint. Eur J Radiol. Song GY, Zhang H, Wang QQ, Zhang J, Li Y, Feng H. Bone contusions after acute noncontact anterior cruciate ligament injury are associated with knee joint laxity, concomitant meniscal lesions, and anterolateral ligament abnormality. PubMed Central 5 Resident, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. Br J Sports Med 38(5):592596, Article Epub 2022 May 3. "Kissing contusion" refers to a bone contusion on both side of the knee joint. Eight of the kissing contusions were associated with anterior cruciate ligament tears, three with menisceal tears, four were isolated lesions, and one was delayed, following a menisceal tear. In tensile load, on the other hand, bones pull apart leading to distraction across the joint and traction on stabilizing structures. The depth of LFNS and the presence of KC were determined on MRI findings. Boks SS, Vroegindeweij D, Koes BW, Bernsen RM, Hunink MG, Bierma-Zeinstra SM. 1998;69:2914. We're here to help! These contusions are generally found by magnetic resonance imaging and most cases are associated with ligamentous or menisceal injuries. You can help Wikipedia by expanding it. Mild high signal of the distal semimembranosus insertion, however, the remaining posteromedial corner structures appear uninjured. Language links are at the top of the page across from the title. Horizontal Rafting Plate for Treatment of the Tibial Plateau Fracture. 2000;20:S13551. Other structures are injured less frequently and have weaker associations with bone bruise distribution. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Extensive posterior capsular edema in keeping with a hyperextension injury. Green DW, Hidalgo Perea S, Kelly AM, Potter HG. Bone Marrow Edema Injury Patterns in the Pediatric Knee: An MRI Study. PDFS Saggital: Bone marrow oedema at proximal tibia in Dashboard injury. N Z Med J. Bone bruises: MR characteristics and histological correlation in the young pig. Radiology 184(3):855858, Dimitriou D, Reimond M, Foesel A et al (2021) The deep lateral femoral notch sign: a reliable diagnostic tool in identifying a concomitant anterior cruciate and anterolateral ligament injury. Boks SS, Vroegindeweij D, Koes BW, Hunink MG, Bierma-Zeinstra SM. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Chi-square = 1.926, p =0.3817 i.e. Analytical Services; Analytical Method Development and Validation They can be used to diagnose ACL injuries. CAS Patterns of bone bruise in knee injury. and transmitted securely. Bone marrow contusion usually resolves in 6-8 weeks [6]. -. 99 0 obj Bone marrow edema and low T1 signal through the proximal tibial epiphysis anteriorly associated periosteal edema. In this study, the time gap between injury and doing MRI was not considered. Kapelov et al., conducted a study to demonstrate that T2 weighted fast spin echo (FSE) images with spectroscopic fat saturation (FS- FSE) increase conspicuity between marrow contusion and normal marrow in post traumatic knee and found bone marrow contusion in 21 out of 76 cases (27.6%) which is less than our study (69%) [11]. MeSH The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The most common sites of bone bruising were the anteromedial tibial plateau (48%) and anterolateral tibial plateau (44%). HHS Vulnerability Disclosure, Help 21033-6-01). <>stream Therefore, an influence by the number of bone bruises on healing time was marked; the higher the number, the more likely that there will be one slowly resolving lesion. 33 0 obj Incidence and location of bone bruises after acute posterior cruciate ligament injury. Google Scholar. 2002;10:96101. The .gov means its official. When femur rotates internally on a fixed tibia on the flexed knee; contraction of the quadriceps occurs, leading to lateral dislocation of the patella out of the trochlear groove [8,14]. Asai K, Nakase J, Oshima T, Shimozaki K, Yoshimizu R, Tsuchiya H (2020) Partial resection of the infrapatellar fat pad during anterior cruciate ligament reconstruction has no effect on clinical outcomes including anterior knee pain. This mechanism of injury involves other soft tissue structures like tears/posterior capsule and arcuate ligament, medial collateral ligament (MCL) and the menisci. Objective: Google Scholar. Patients with a knee MRI within one year of hyperextension injury were identified at our institution over a 7 year period. Associated MCL injury is noted in 31 cases (79.5%). Increase in interstitial water content and hyperperfusion contributes to bone marrow oedema formation. 2007;189:55662. . In these 16 cases, contusion in medial compartment was noted in 2 cases (12.5%) [13]. The KIS Imaging program was designed to direct patient care, through a concierge service, in which employees and employers can realize up to an 80% savings on all major imaging. Arch Orthop Trauma Surg 140(11):17511757, Article MR feature of bone bruising reflects increase in water content in marrow cavity as a result of haemorrhage, therefore water sensitive sequence like fat saturated T2W, PD weighted image or STIR are used [1,11,12]. Arch Orthop Trauma Surg 140(12):20132020, Article AJR Am J Roentgenol. Lim YS, Peh WC. Radiographics. Epub 2013 Jun 6. 2023 Feb;19(1):107-112. doi: 10.1177/15563316221092320. PubMed Contusions of both surfaces of the joint are known as kissing contusions. Waldn M, Krosshaug T, Bjrneboe J, Andersen TE, Faul O, Hgglund M. Three distinct mechanisms predominate in non-contact anterior cruciate ligament injuries in male professional football players: a systematic video analysis of 39 cases. 2019 Nov;27(11):3633-3637. doi: 10.1007/s00167-019-05490-7. PDFS Coronal: Bone marrow oedema at Medial femoral condyle and Metadiaphysis. Knee Surg Sports Traumatol Arthrosc 26(5):13991405, Lodewijks P, Delawi D, Bollen TL, Dijkhuis GR, Wolterbeek N, Zijl JAC (2019) The lateral femoral notch sign: a reliable diagnostic measurement in acute anterior cruciate ligament injury. bone contusion) can give clues for the mechanism and associated injuries. Prevalence and location of bone bruises associated with anterior cruciate ligament injury and implications for mechanism of injury: a systematic review. Graf BK, Cook DA, De Smet AA, Keene JS. Bisson LJ, Kluczynski MA, Hagstrom LS, Marzo JM. A 124(62%) had trauma in right knee and 76(38%) in left knee. A 14-year-old male football player with chronic anterior knee pain who experienced acute knee pain after jumping and landing awkwardly. Prognosis is particularly influenced by the presence of osteoarthritis. Other 2 cases (50%) are hyperextension with valgus component and kissing contusion at medial aspect of proximal tibia and distal femur caused due to kicking while playing football. Bone marrow oedema is responsible for patient symptoms and may lead to early degenerative changes [7]. A biomechanical approach to MRI of acute knee injuries. Clin Imaging. [101 0 R] Lateral-compartment bone contusions in adolescents with intact anterior cruciate ligaments. 1 Kacey Court, Suite 100, Mechanicsburg, Pa, 17055. uuid:a4a67e1a-1dd1-11b2-0a00-880000000000 HWnWhl2 p$%SgdR`Qvs4a^q~z]&O_F?`7%|8W.Zyxc\4x{gJSp>)nO|-6bhLCntyFTVe7WwtR?fs;fLh;>|*E{mIvqGUlT! -, Radiology. Bone marrow contusions are frequently identified at magnetic resonance imaging after an injury to the musculoskeletal system, and the mechanism of injury can be determined by studying the distribution of bone marrow edema, which enables one to predict with accuracy the specific soft-tissue abnormalities that are likely to be present. In suspected ACL injury, bone marrow contusion may not be necessarily present. In our study, bone marrow oedema was seen in 138 cases (69%) out of 200 cases. The positive rate of KC in the experimental group (183/500) was markedly higher than that in the control group (3/500) (P<0.05). Materials and methods: By directing imaging . Hyperextension results in the "kissing" contusion pattern involving the anterior aspect of the proximal tibia and distal femur. Google Scholar. endobj Xie D, Murray J, Lartey R, Gaj S, Kim J, Li M, Eck BL, Winalski CS, Altahawi F, Jones MH, Obuchowski NA, Huston LJ, Harkins KD, Friel HT, Damon BM, Knopp MV, Kaeding CC, Spindler KP, Li X. Osteoarthritis Cartilage. Effusion in the adjacent deep infrapatellar bursa. Chin YC, Wijaya R, Chong le R, Chang HC, Lee YH. Radiographic features Five classic bone contusion patterns have been described 1-4: pivot-shift injury valgus stress to flexed and externally rotated knee HG contributed to the article writing and data collection. Perin B, Nardacchione R, Bonaga S, Angelini F, Girotto A, Giovagnoni A, et al. bubble tea consumption statistics australia. Radiology 182(1):221224, Niitsu M, Kuramochi M, Anno I, Itai Y (1995) Secondary signs of anterior cruciate ligament tear at MR imaging. Pattern of marrow oedema as per classification. 3. Bone bruising of the knee. (2008) ISBN:0323076211. In present study transient dislocation of patella pattern is noted in 3 cases (2.2%). Among the 200 cases, bone marrow contusion was noted in 138 cases (69%) and absent contusion in 62 cases (31%). 1993 Mar-Apr;21(2):220-3 In this study, inclusion criteria included history of knee injury within 6 weeks or suspected ACL injury [12].

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