kissing contusion knee radiology

They found that all the lesions in one patient do not heal at exactly the same speed. A knee contusion can range from mild to severe. Medial and lateral meniscal tears usually involving the . Bone marrow oedema may also show delayed enhancement following administration of gadolinium DTPA. 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 official website and that any information you provide is encrypted Mandalia V, Fogg AJB, Chari R, Murray J, Beale A, Henson JHL. XZ contributed to part of the statistics of the article. Application of biomechanical approach in MR interpretation helps in effortless assessment of osseous contusion and ligament rupture and mark delicate but significant abnormalities. Google Scholar, Kanakamedala AC, Burnham JM, Pfeiffer TR et al (2018) Lateral femoral notch depth is not associated with increased rotatory instability in ACL-injured knees: a quantitative pivot shift analysis. . Orthop Surg. 2005;118(1209):U1301. 31 0 obj endstream ACL tears are classified into three grades: Grade I ACL tears represent intraligamentous injury without a change in ligament length. Meyer EG, Baumer TG, Haut RC. In present study clip injury pattern is noted in 39 cases (28.6%). Mechanism of traumatic knee injuries and MR findings. Boks SS, Vroegindeweij D, Koes BW, Bernsen RM, Hunink MG, Bierma-Zeinstra SM. Other structures are injured less frequently and have weaker associations with bone bruise distribution. Am J Sports Med. 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. Bone bruising of the knee. 2015;43(10):251521. 2005;60:62736. Presence of contusion may also effect management of knee injuries often requiring prolonged rest even in absence of surgical correctible lesion and establishing diagnosis of bone marrow contusion may obviate further costly work up like arthroscopy. 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. The presence of a double sulcus showed significant association with anteromedial kissing contusions (OR = 7.8, p = 0.03). Furthermore, it is anterior tibial oedema rather than the presence of kissing lesions than predicts cruciate ligament injury (OR = 10.5, p = 0.02). In compressive load, bones collide leading to impaction. 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. No funding was received to assist with the preparation of this manuscript. By directing imaging to outpatient sites, not hospital settings, it creates a better patient experience while yielding substantial savings. -, Arthroscopy. MRIs, plain radiographs and clinical details of these patients were reviewed. Orthop J Sports Med. 1997;93(12):404. There were high rates of injury to the posterior capsule (52%), ACL (40%) and PCL (40%) but lower rates of injury to the menisci (20%), medial and lateral collateral ligaments (16%) and posterolateral corner (16%). Bone contusions of the posterior lip of the medial tibial plateau (contrecoup injury) and associated internal derangements of the knee at MR imaging. Contusions of both surfaces of the joint are known as kissing contusions. The pattern of bone bruise in knee injuries (a.k.a. 2000;20 Spec No (suppl_1): S135-51. Inclusion criteria were patients with recent knee injuries (<6weeks) and normal plain radiograph with no signs of pathology. Soft tissue abnormalities may include injury of ACL or PCL and a meniscal injury along with injury of the popliteal neurovascular structure, complete disruption of the posterolateral complex, gastrocnemius injury [8]. Imaging the knee: Ligaments. Careers, Unable to load your collection due to an error. Bone contusion and associated meniscal and medial collateral ligament injury in patients with anterior cruciate ligament rupture. Part of Springer Nature. Inpatient imaging services are available 24/7. Knee Surg Sports Traumatol Arthrosc. In this study, the time gap between injury and doing MRI was not considered. 2000;20:S13551. 2022. Conclusions: Following knee hyperextension, bone bruising patterns may be associated with cruciate ligament injury. To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint. 1993;189:9014. Texas Health Care Imaging has been registered with the National Provider Identifier database since May 25, 2021 and its NPI number is 1053986786 (certified on 05/25/2021). CAS PubMedGoogle Scholar. Bone bruise of the knee: histology and cryosections in 5 cases. Magnetic Resonance Imaging of Sports injuries of knee. https://doi.org/10.1007/s00256-017-2754-y, https://doi.org/10.1016/j.arthro.2016.03.015. A prospective study of the association between bone contusion and intra-articular injuries associated with acute anterior cruciate ligament tear. 2023 Springer Nature Switzerland AG. bubble tea consumption statistics australia. By analysing bone marrow contusion pattern, type/mode can be determined in most of the cases. None of the knees had been injured before. Notch syndrome refers to the enlarged and deepened lateral femoral condyle. The LFNS and KC have strong clinical significance in the diagnosis of ACL injuries. -. Bisson LJ, Kluczynski MA, Hagstrom LS, Marzo JM. Following knee hyperextension, bone bruising patterns may be associated with cruciate ligament injury. The most common sites of bone bruising were the anteromedial tibial plateau (48%) and anterolateral tibial plateau (44%). Incidence and location of bone bruises after acute posterior cruciate ligament injury. Provided by the Springer Nature SharedIt content-sharing initiative, Over 10 million scientific documents at your fingertips, Not logged in 2022 Oct 17;10(10):23259671221120636. doi: 10.1177/23259671221120636. Other structures are injured less frequently and have weaker associations with bone bruise distribution. This case demonstrates a hyperextension knee injury consisting of partial posterior cruciate ligament tear proximal tibia epiphysis bone contusion and minor "kissing contusion" of the lateral femoral condyle posterior soft tissue injuries involving the knee joint capsule, fibular attachment of soleus and distal semimembranosus tendon Vojnosanit Pregl. The knee may also be swollen and bruised. Associated MCL injury is noted in 31 cases (79.5%). Magnetic Resonance Imaging of Bone Marrow: A Review Part II. Due to superior ability to produce high resolution images with exquisite soft tissue contrast, MRI is the modality of choice for evaluation of bone marrow. DOI: 10.1148/radiographics.20.suppl_1.g00oc19s135 PMID: 11046168. In one of these patients, the lesion was still seen at 1-month follow-up, and in the other patient, complete resolution occurred after 10 months. 33 0 obj Type/Mode of injury in these cases are: impact during car accident in 4 cases, fall on flexed knee while playing cricket in 1 case, while getting downstairs in 1 case and fall from bike in flexed knee in 2 cases. 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. (2008) ISBN:0323076211. Tax calculation will be finalised during checkout. Soft tissue injury associated with dash board injury includes PCL and posterior joint capsule. This mechanism of injury involves other soft tissue structures like tears/posterior capsule and arcuate ligament, medial collateral ligament (MCL) and the menisci. The values of notch depth in patients who had ACL rupture concomitant lateral MT injuries and medial collateral ligament (MCL) injuries were 1.120.64 and 1.230.74mm, respectively, which were significantly higher than those in patients with only ACL injury (0.890.49mm) (P<0.05). Liu ZY, Zhang JL, Liu C, Cao Q, Shen QJ, Zhao JC. 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. Looking for more information? 99 0 obj PubMed In current study unclassifiable injuries pattern was noted in 6 cases. The usefulness of the oblique coronal plane in knee MRI on the evaluation of the posterior cruciate ligament. eCollection 2022 Oct. Moran J, Katz LD, Schneble CA, Li D, Kahan JB, Wang A, Porrino J, Jokl P, Hewett TE, Medvecky MJ. MRI Introduction Anterior cruciate ligament (ACL) injuries are among the most common sports injuries. Call Us Today! Disabling symptoms are often prolonged. 2007;189:55662. [Table/Fig-10,,1111 and and12]12] show the aetiologies and location for pivot shift injury, Type /Mode of injury among dashboard injury pattern (8 cases) were - Impact from dashboard in 4 cases, fall from bike (2 cases), running downstairs (1 case) and fall while paying cricket (1 case). 2022 Dec;30(12):1647-1657. doi: 10.1016/j.joca.2022.08.006. no financial relationships to ineligible companies to disclose. This injury most commonly occurs when the knee strikes against the dashboard during an automobile accident or fall against the ground on flexed knee. of knee injury in pediatric patients. Transient lateral patellar dislocation: diagnosis with MR imaging. For outpatient testing, Valley Regional Imaging is open Monday to Friday from m 8 a.m. to 8 p.m. Saturday hours are available for obstetrics (OB) and CAT Scans only from 8 a.m. to noon. In this study, inclusion criteria included history of knee injury within 6 weeks or suspected ACL injury [12]. Clipboard, Search History, and several other advanced features are temporarily unavailable. Fornalski S, McGarry MH, Csintalan RP, Fithian DC, Lee TQ. [12] Our team of experienced agents will hand hold the member through theentireprocess. Emerg Radiol 2:129134, Article Davies NH, Niall D, King LJ, Lavelle J, Healy JC. Whilst anterolateral tibial plateau oedema strongly predicted PCL injury [OR = 26.0, p = 0.003], ACL injury was associated with a variable pattern of bone bruising. 2013;41(8):18017. Bookshelf Google Scholar, Wierer G, Simetinger T, Hudelmaier M, Moroder P, Hoffelner T (2020) Fate of the lateral femoral notch following early anterior cruciate ligament reconstruction. FOIA Jeli D, Masulovi D. Bone bruise of the knee associated with the lesions of anterior cruciate ligament and menisci on magnetic resonance imaging. PubMed -. Radiographic features Five classic bone contusion patterns have been described 1-4: pivot-shift injury valgus stress to flexed and externally rotated knee A biomechanical approach to MRI of acute knee injuries. No fractures were present on x ray. To establish whether patterns of soft tissue injury following knee hyperextension are associated with post-traumatic bone bruise distribution. and transmitted securely. Bethesda, MD 20894, Web Policies 2 Resident, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. application/pdf Oedema is seen at the anterior aspect of the tibia and, occasionally, at the posterior surface of the patella [8]. Clinical outcome of isolated subcortical trabecular fractures (bone bruise) detected on magnetic resonance imaging in knees. The site is secure. {"url":"/signup-modal-props.json?lang=us"}, Knipe H, Yap J, Al Kabbani A, et al. PubMed Accessibility Mandalia V, Henson JH. 1999 Jun;211(3):747-53 khloe kardashian hidden hills house address. Acta Radiol. government site. Most common location of marrow oedema in pivot shift pattern was posterolateral tibial plateau and lateral femoral condyle and medial tibial condyle and medial femoral condyle in 31 cases (39.7 %) [Table/Fig-9]. This site needs JavaScript to work properly. endobj PubMed Skeletal Radiol 47, 173179 (2018). judge timothy kenny political affiliation. Twenty-five patients were identified (median time from injury to MRI = 24 days). A cross-section study was done on all patients reffered to Krishna Hospital, Karad for MRI knee with history of recent (< 6 weeks) knee injury. Why continue to overpay for your most common Imaging procedures? Epub 2021 Apr 4. Table showing Type/Mode of injury in pivot shift injury. Texas Health Care Imaging is a radiology clinic located in Brownsville, TX. and kissing contusions of the lat-eral femoral condyle and medial tibial pla . Arch Orthop Trauma Surg 140(7):923931, Renstrom P, Ljungqvist A, Arendt E et al (2008) Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement. Tensile load can cause ligament and tendon tears as well as avulsion fracture. Sanders classified bone marrow contusions in five different patterns as: Clip injury, Pivot shift injury, Dashboard injury, Hyperextension injury, and Lateral patellar dislocation [8]. The saggital plane was primarily used to evaluate the bone marrow oedema which was confirmed on coronal images. N Z Med J. "Kissing contusions," a commonly seen secondary sign of ACL injury caused by the previously mentioned pivot-shift mechanism of injury, occur on the posterior aspect of the tibial plateau and the mid to anterior aspect of the femoral condyle (Figure 4). Rangger C, Klestil T, Kathrein A, Indester A, Hamid L. Influence of magnetic resonance imaging on indications for arthroscopy of the knee. At the time the case was submitted for publication Henry Knipe had no recorded disclosures. 1. An official website of the United States government. Terzidis et al., 20 conducted a study on acute knee injuries in 255 athletes with acutely injured knees, 219 MRIs were done within the first month after the injury and 36 within two to four months [13]. This was comparable to study conducted by Kirsch et al., in who reported transient lateral patellar dislocation in 2% cases with acute knee injuries and bone marrow contusion is noted in lateral femoral condyle in 81% and contusion in patella in 19% cases [15]. Many patients coming with complain of pain following injury without radiographic evidence of fracture, MRI yields presence of extensive injury marrow which is characterised by marrow oedema and haemorrhage termed as bone bruise. Arch Orthop Trauma Surg. uuid:a4a67e17-1dd1-11b2-0a00-340827bd7200 Check for errors and try again. 13 0 obj Knee kinematics during noncontact anterior cruciate ligament injury as determined from bone bruise location. Correspondence to Associated Soft tissue injuries include ACL and medial meniscus [8]. 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]. Epub 2021 May 11. Injury to the Meniscofemoral Portion of the Deep MCL Is Associated with Medial Femoral Condyle Bone Marrow Edema in ACL Ruptures. At the time the article was last revised Joshua Yap had <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB]/XObject<>>>/Rotate 0/TrimBox[57.25999 58.11 666.34 848.69299]/Type/Page>> Bone bruise represents as acute, occult microfractures of subchondral trabecular bone with subsequent haemorrhage, oedema and hyperemia. the contents by NLM or the National Institutes of Health. Comparison of bone contusion seen by MRI in partial and complete tears of the anterior cruciate ligament. In total 200 cases, bone marrow contusion was noted in 138 cases (69%) and absent contusion in 62 cases (31%). Extensive posterior capsular edema in keeping with a hyperextension injury. J Bone Joint Surg Am. Ali, A.M., Pillai, J.K., Gulati, V. et al. Bone Marrow Edema Injury Patterns in the Pediatric Knee: An MRI Study. PubMed 2023-05-01T23:01:26-07:00 Am J Sports Med. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The patients age ranged from 17-65 years and majority of patients were in 21-30years age group. 2004;32:16817. Correlation between various pattern of bone marrow oedema and type/mode of injury. 2021 May;13(3):966-978. doi: 10.1111/os.12997. Patients were scanned using 1.5 Tesla Seimens Avanto (Tim + Dot) with Tx/Rx 15 channel knee coil # Tim. 2016 Nov;32(11):2331-2341 Reflecting presence of increased free water oedema, appears hyperintense on inversion recovery and fat suppressed images and shows increase diffusivity on Diffusion weighted images [10]. We're here to help! Google Scholar. Kessler R, Campbell S, Wong D, Mansfield LB. Bone contusions are often identified at magnetic resonance imaging (MRI) in the acutely injured knee. Although bone marrow oedema is nonspecific and has a similar appearance in inflammatory and neoplastic disorders, a traumatic cause is usually obvious on the basis of the clinical history, location of bone marrow oedema and the presence of other trauma related findings. Our results therefore suggest that kissing contusions are more common following knee hyperextension than in other forms of knee injury and predominantly affect the medial side. A total of 1000 patients were enrolled in this study, including 500 patients with ACL injuries who assigned to experimental group and 500 patients with meniscal tear (MT) who allocated to control group. Diagnostic value of the lateral femoral notch sign and kissing contusion in patients with anterior cruciate ligament injuries: a casecontrol study. Arch Orthop Trauma Surg 143, 927934 (2023). volume47,pages 173179 (2018)Cite this article. Am J Sports Med. Careers. 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. Unclassified injury pattern in 6 cases with type /mode of injury and location of bone marrow contusion. PDFS Saggital: Bone marrow oedema at Medial femoral and Medial tibial condyle in Hyperextension injury. This is a preview of subscription content, access via your institution. NAME, ADDRESS, E-MAIL ID OF THE CORRESPONDING AUTHOR: Dr. Ashish Garg, A-4, Ashok Nagar, Mandoli Road, Shahdara, Delhi-110093, India. 21033-6-01). Part of Springer Nature. Type/Mode of injury were twisting injury while getting downstairs (1 case), twisting injury while doing household work (1 case) and injury while playing football (1 case). Epub 2022 Mar 1. Follow up scan could not be done to establish the presumable diagnosis of bone marrow contusion. Bone marrow oedema is responsible for patient symptoms and may lead to early degenerative changes [7]. Eur J Radiol. 3. Deangelis JP, Spindler KP. You can help Wikipedia by expanding it. Exclusion criteria were history of any infection, surgery or neoplasm of knee joint, patients having any prosthetic heart valve implant, any pacemaker implant, aortic stent graft, cochlear implant or any metallic orthopedic implants, any joint replacement surgery and claustrophobic patients. Frequent abnormalities found on MR imaging include labral tear or injury, stress fracture, and avascular necrosis . 8600 Rockville Pike Fill out the form below and a representative will be in touch. Out of 200 patients, 32 were women (16%) and 168 men (84%). Check for errors and try again. The diagnostic outcome of LFNS was not in agreement with that of KC, as there was a poor coincidence according to the Kappa coefficient (Kappa=0.155<0.4, P=0.035). The knee is a major weight bearing joint that provides mobility and stability during physical activity as well as balance while standing. MRI of affected knee joint was done as per imaging protocol and images stored in compact disc. Contusion is seen in the anterior aspect of the distal femur and proximal tibia or located in medial femoral and tibial condyle (valgus force applied).

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