Best Practice Case Studies-Posterior Cruciate Ligament Tear

Video Transcription

Hi, this is Sagar Wagle, one of the musculoskeletal radiology fellows at Stanford University.  We have a case of a 16 year old offensive lineman with knee pain after a football game.  So this is a knee MRI of the patient. Before we go into the MRI, let's look at a case of a normal PCL on the MR. As you scroll through the images,  we first see the ACL. It's low in signal intensity and as we keep scrolling we see the PCL.  The PCL fibers have a lower signal intensity as compared to the ACL and they are also thicker than the ACL.  So this is the normal appearance of PCL.  Let's look at a case of a PCL tear. As we start the image, we can see that there is joint diffusion present.  As we keep going through the images, we see that the ACL fiber coming to view. We see a little bit of the digital PCL fibers.  But as we keep scrolling, we can never make the PCL fiber continuously go and attach more proximally. The proximal  PCL fibers are here. They are really thickened, increase signal intensity and  there may be a few strands that are connecting but for the most part, there's a high grade tear of the PCL.  So our normal PCL is on the right side and we can see that there's a high grade or full thickness tear of the PCL.  There may be a couple of strands attaching that we don't see in this image.  So if you compare the normal PCL to our original case, we can see that in the original case, the PCL fibers are really thickened.  They have increased signal intensity. The digital part is continuous but proximally they are not continuous.  So there is a high grade tear of the PCL somewhere around here. Thank you for watching the video.

Video Summary

The video features Sagar Wagle, a musculoskeletal radiology fellow at Stanford, discussing a knee MRI case of a 16-year-old football lineman with knee pain. He compares normal and torn posterior cruciate ligament (PCL) MRIs. Normal PCL fibers have low signal intensity and thickness, while in a tear, they show increased signal intensity and thickening. The torn PCL lacks continuous proximal fibers, indicating a high-grade tear. The video emphasizes the differences between a normal PCL and a high-grade PCL tear, which is visible due to discontinuity and thickened fibers in the MRI.

Meta Tag

Edition 3rd Edition

Related Case 3rd Edition, CASE 30

Topic Knee

Keywords

3rd Edition, CASE 30

3rd Edition

Knee

knee MRI

posterior cruciate ligament

high-grade tear

musculoskeletal radiology

Sagar Wagle