1998 Jun;69(3):291-4 the contents by NLM or the National Institutes of Health. A prospective study of the association between bone contusion and intra-articular injuries associated with acute anterior cruciate ligament tear. Liu ZY, Zhang JL, Liu C, Cao Q, Shen QJ, Zhao JC. {"url":"/signup-modal-props.json?lang=us"}, Knipe H, Yap J, Al Kabbani A, et al. endobj Bone marrow oedema may also be rarely seen at adductor tubercle of the medial femoral condyle due to avulsion injury of the medial patellofemoral ligament. 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. "The appearance of kissing contusion in the acutely injured knee in the athletes", https://en.wikipedia.org/w/index.php?title=Kissing_contusion&oldid=903873252, Creative Commons Attribution-ShareAlike License 3.0, This page was last edited on 28 June 2019, at 13:40. https://doi.org/10.1007/s00256-017-2754-y, https://doi.org/10.1016/j.arthro.2016.03.015. 2022 Jan 11;17(1):17. doi: 10.1186/s13018-022-02912-0. Pivot shift pattern is most common contusion pattern and the most common type/mode of injury is sports related injury. 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. Furthermore, it is anterior tibial oedema rather than the presence of kissing lesions than predicts cruciate ligament injury (OR = 10.5, p = 0.02). 2 cases (50%) are hyperextension injury with kissing contusion at anterior aspect of proximal tibia and distal femur caused due to hit by car in RTA. 2005;60:62736. 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 Knee Surg Sports Traumatol Arthrosc 23(8):22502258, Hoffelner T, Pichler I, Moroder P et al (2015) Segmentation of the lateral femoral notch sign with MRI using a new measurement technique. The appearance of kissing contusion in the acutely injured knee in the A load that is too low to cause cortical fracture may be sufficient to disrupt trabecular bone and produce marrow contusion. PubMed The most common sites of bone bruising were the anteromedial tibial plateau (48%) and anterolateral tibial plateau (44%). Bone contusion patterns of the knee at MR imaging: footprint of the mechanism of injury. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. This mechanism of injury involves other soft tissue structures like tears/posterior capsule and arcuate ligament, medial collateral ligament (MCL) and the menisci. endobj Rangger C, Klestil T, Kathrein A, Indester A, Hamid L. Influence of magnetic resonance imaging on indications for arthroscopy of the knee. Bone contusions of the posterior lip of the medial tibial plateau (contrecoup injury) and associated internal derangements of the knee at MR imaging. After knee injury, bone marrow oedema is frequently subchondral in location [4]. 2014 Feb;44(2):281-93. doi: 10.1007/s40279-013-0116-z. "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). Kung JW, Yablon CM, Eisenberg RL. sharing sensitive information, make sure youre on a federal Kissing contusion is a significant injury often associated with ligamentous or menisceal injuries. Calvo-Gurry M, Hurley ET, Withers D, Vioreanu M, Moran R. Knee Surg Sports Traumatol Arthrosc. The depth of LFNS and the presence of KC were determined on MRI findings. KIS Imaging is the nations largest direct contracting imaging network with over 2,600 providers covering all major imaging needs: MRI, CT and PET. Follow up scan could not be done to establish the presumable diagnosis of bone marrow contusion. 1993;189:9014. 1996 Jan;198(1):205-8 KIS Imaging -, Radiology. 1 Kacey Court, Suite 100, Mechanicsburg, Pa, 17055. This study was approved by the ethical committee of Beijing Tsinghua Changgung Hospital (No. Extensive posterior capsular edema in keeping with a hyperextension injury. Contusions of both surfaces of the joint are known as kissing contusions. Ali, A.M., Pillai, J.K., Gulati, V. et al. [11] Anterior displacement of tibia refers to increased distance from the posterior cortex of the lateral tibial plateau to the posterior cortex of the femur. MRIs, plain radiographs and clinical details of these patients were reviewed. Bone contusion is also noted in posterior lip of the medial tibial condyle [8] or medial femoral condyle and medial tibial condyle [7]. Careers. Compressive load causes bone marrow contusion and, if sufficient in magnitude, depressed cortical fracture. Incidence and location of bone bruises after acute posterior cruciate ligament injury. 2014;55(8):9618. 2023 Springer Nature Switzerland AG. Chi-square: 41.961 and p <0.001 suggests that clip injury was significantly high in fall from two wheeler and pivot shift injury was significantly higher in sports related injury. PDFS Saggital: Bone marrow oedema at Lateral femoral condyle in Clip injury pattern. Provided by the Springer Nature SharedIt content-sharing initiative, Over 10 million scientific documents at your fingertips, Not logged in Injury in PCL is seen in all the cases. 2019 Nov;27(11):3633-3637. doi: 10.1007/s00167-019-05490-7. 2010 Dec;38(12):2502-8. doi: 10.1177/0363546510376232. Twenty-five patients were identified (median time from injury to MRI = 24 days). khloe kardashian hidden hills house address. Hayes CW, Brigido MK, Jamadar DA, Propeck Tim. Imaging Services | HCA Valley Regional Medical Center | Valley Regional Am J Sports Med 28(1):6873, Gentili A, Seeger L, Yao L, Do H (1994) Anterior cruciate ligament tear: indirect signs at MR imaging. Bone bruise, Compressisve force, Early degeneration, Microfracture, Torsional force. PubMedGoogle Scholar. 2005;118(1209):U1301. Correlation between various pattern of bone marrow oedema and type/mode of injury. PDFS Saggital: Bone marrow oedema at Lateral femoral and posterolateral tibial plateau in Pivot shift injury. Nippon Igaku Hoshasen Gakkai Zasshi 55(6):375379, CAS PubMed Green DW, Hidalgo Perea S, Kelly AM, Potter HG. 2002;10:96101. kissing contusion ankle "Kissing contusion" refers to a bone contusion on both side of the knee joint. The Lateral Femoral Notch Sign | Radiology Background: Google Scholar. 2011 Aug 17;93(16):1510-8. doi: 10.2106/JBJS.J.01320. 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. Ready to get started? 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. Mechanism-based pattern approach to classification of complex injuries of the knee depicted at mr imaging. 5 Resident, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. Meniscal injury was unrelated to the extent or pattern of bone bruising. Bone bruises: MR characteristics and histological correlation in the young pig. Minor focus of edema in the anterior aspect of the lateral femoral condyle. Meniscal injury was unrelated to the extent or pattern of bone bruising. Bone contusion and associated meniscal and medial collateral ligament injury in patients with anterior cruciate ligament rupture. Our study only involves the image information of patients. <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/TrimBox[57.25999 58.11 666.34 848.69299]/Type/Page>> For KC, the corresponding values were 36.6% and 99.4%, respectively. The lateral femoral notch sign following ACL injury: frequency, morphology and relation to meniscal injury and sports activity. Knee Surg Sports Traumatol Arthrosc. Among the clip injury pattern, most common type/ mode of injury was two wheeler accident which was seen in 26 out of 39 cases (66.6%) [Table/Fig-7,,88]. Bisson LJ, Kluczynski MA, Hagstrom LS, Marzo JM. Conclusions: HW contributed to some imaging data and surgery. Comparison of magnetic resonance imaging for patients with a - LWW Would you like email updates of new search results? Knee Surg Sports Traumatol Arthrosc 29(4):10181024, Cobby MJ, Schweitzer ME, Resnick D (1992) The deep lateral femoral notch: an indirect sign of a torn anterior cruciate ligament. 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). Correspondence to 1997;93(12):404. 8600 Rockville Pike Matrix in various sequences were listed as : T1 Saggital 307 x 384, T2 Axial - 314 x 448, T2 Saggital 314 x 448, PD Saggital 307 x 384, PD Coronal 355 x 384, PDFS Saggital 288 x 384, PDFS Coronal 311 x 384, MEDIC Axial 240 x 320. Bethesda, MD 20894, Web Policies Knee joint is one of strongest joint in body and allows transmission of body weight to leg. MRI of Sports Injuries in Children and Adolescents: What's - Springer 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. A 124(62%) had trauma in right knee and 76(38%) in left knee. DOI: 10.1148/radiographics.20.suppl_1.g00oc19s135 PMID: 11046168. 2023 Jan;51(1):58-65. doi: 10.1177/03635465221131551. Chin YC, Wijaya R, Chong le R, Chang HC, Lee YH. Disabling symptoms are often prolonged. 1020 AJR:196, May 2011 Pai and Strouse ulation [2, 3]. J Orthop Surg Res. In distraction injury, excessive tension may damage the joint capsule, retinacula, ligaments, and tendons as well as their osseous attachment sites. 2021 May;13(3):966-978. doi: 10.1111/os.12997. J Biomech Eng. Horizontal Rafting Plate for Treatment of the Tibial Plateau Fracture. An official website of the United States government. This site needs JavaScript to work properly. Grade II ACL tears represent intraligamentous injury and an increase in ligament length. Epub 2022 May 3. Bone contusion and associated meniscal and medial collateral ligament injury in patients with anterior cruciate ligament rupture. Hong CK, Lin YJ, Cheng TA, Chang CH, Hsu KL, Kuan FC, Su WR. A prospective study of the association between bone contusion and intra-articular injuries associated with acute anterior cruciate ligament tear. The appearance of kissing contusion in the acutely injured knee in the Bone bruise represents as acute, occult microfractures of subchondral trabecular bone with subsequent haemorrhage, oedema and hyperemia. 99 0 obj LF directed the writing of the article. 2004;38:5926. Hyperextension injuries of the knee: do patterns of bone bruising 5 0 obj Conclusions: Following knee hyperextension, bone bruising patterns may be associated with cruciate ligament injury. Journal of Clinical and Diagnostic Research : JCDR, Lateral tibial plateau and medial femoral condyle, Medial femoral condyle, Metadiaphysis femur, Medial femoral condyle, proximal tibia and head. 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 location of bone marrow oedema and the presence of other trauma related findings. Arch Orthop Trauma Surg 128(11):13131316, Terzidis IP, Christodoulou AG, Ploumis AL, Metsovitis SR, Koimtzis M, Givissis P (2004) The appearance of kissing contusion in the acutely injured knee in the athletes. Bretlau T, Tuxe J, Larsen L, Jrgensen U, Thomsen HS, Lausten GS. The knee is a major weight bearing joint that provides mobility and stability during physical activity as well as balance while standing. In 6 cases bone marrow contusion could not be explained by various patterns. Five patterns of bone marrow contusion was noted in 138 cases: Clip injury in 39 cases (28.3%) [Table/Fig-1a&b], Pivot shift injury in 78 cases (56.5%) [Table/Fig-2a&b], Dashboard injury in eight cases (5.8%) [Table/Fig-3], Hyper extension injury in four cases (2.9%) [Table/Fig-4], Lateral patellar dislocation in three cases (2.2%) [Table/Fig-5]. and transmitted securely. At the time the article was last revised Joshua Yap had Mair SD, Schlegel TF, Gill TJ, Hawkins RJ, Steadman JR. 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]. Contusions of both surfaces of the knee joint are known as kissing contusions. CAS 5 out of 8 patients with a double sulcus on the lateral radiograph had ACL injury. Associated MCL injury is noted in 31 cases (79.5%). Archives of Orthopaedic and Trauma Surgery, https://doi.org/10.1007/s00402-022-04366-9. Bone bruise patterns in knee injuries: where are they found? Tax calculation will be finalised during checkout. Bone marrow contusion at posterior lip of medial tibial condyle was seen in 59 cases. from publication: The appearance of kissing contusion in the acutely injured knee in the athletes | Bone contusions are often identified at magnetic resonance imaging (MRI) in the acutely. Twenty of the 23 patients had follow-up imaging. Patient was placed in supine position with knee externally rotated 10-20 degree 21. In many cases, Bone marrow contusion might have resolved at time of MRI. A 30-year-old woman with acute knee injury. A thorough understanding of knee injury patterns and their mechanisms may help achieve more accurate assessment of injuries [8]. The lateral femoral notch sign (LFNS) and the kissing contusion (KC) are two indirect signs of anterior cruciate ligament (ACL) injuries. 1989 Sep;27(5):983-1002 Am J Sports Med. HHS Vulnerability Disclosure, Help This site needs JavaScript to work properly. (PDF) The appearance of kissing contusion in the acutely injured knee Epub 2022 Mar 1. The patients age ranged from 17-65 years and majority of patients were in 21-30years age group. A biomechanical approach to MRI of acute knee injuries. kissing contusion ankle Imaging the knee: Ligaments. The datasets used or analysed during the current study are available from the corresponding author on reasonable request. Boks et al., conducted a study of the natural course of bone bruises in posttraumatic knees and to describe possible determinants of this course and concluded that Median healing time of bone bruises is 42.1 weeks [5]. PDFS Coronal: Bone marrow oedema at Medial femoral condyle and Metadiaphysis. The appearance of kissing contusion in the acutely injured knee in the 10 0 obj Prognosis is particularly influenced by the presence of osteoarthritis. Oedema is seen at the anterior aspect of the tibia and, occasionally, at the posterior surface of the patella [8]. 2022 Oct 17;10(10):23259671221120636. doi: 10.1177/23259671221120636. Epub 2021 May 11. In six cases (4.3%) no pattern of bone marrow contusion could be explained and was categorized as unclassified pattern [Table/Fig-6]. The .gov means its official. 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. Home; Service. Am J Sports Med. see full revision history and disclosures, posterior soft tissue injuries involving the knee joint capsule, fibular attachment of soleus and distal semimembranosus tendon. Google Scholar. 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. Oedema or interisital fluid within marrow extracellular space similar to free fluid shows long T1 and T2 decay characteristics and appear hypointense on T1 and hyperintense on T2W. MRI is used widespread to interpret more complex injuries. 2008;36:804. Traumatic Bone Bruises in the Athlete's Knee. uuid:a4a67e17-1dd1-11b2-0a00-340827bd7200 MRI of affected knee joint was done as per imaging protocol and images stored in compact disc. In impaction, the compressive force directly strikes cortical bone and is dissipated into trabecular bone [4]. 255 MRI examinations in athletes with acutely injured knees (197 men; 58 women; mean age 24.2 years) were reviewed by two independent examiners; 219 MRIs were done within the first month after the injury and 36 within two to four months. official website and that any information you provide is encrypted Terzidis IP, Christodoulou AG, Ploumis AL, Metsovitis SR, Koimtzis M, Givissis P. The appearance of kissing contusion in the acutely injured knee in the athletes. Radiology. Bone contusion and associated meniscal and medial collateral ligament injury in patients with anterior cruciate ligament rupture. 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]. 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]. Learn more about Institutional subscriptions. In this study, patients with history of knee injury <6 weeks were considered as recent knee injuries. PubMed Central Clin Orthop Relat Res. 2021 Jun;13(4):1343-1350. doi: 10.1111/os.12967. Radiology. In compressive load, bones collide leading to impaction. 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). According to study conducted by Terzidis et al., Kissing contusion in acute knee injury is noted in 16 cases out of 225 (7.1%). The oedema pattern & suspected type/mode of injury on basis of MRI were then correlated with detailed patients history on mode of injury. Unable to process the form. Byrd JM, Colak C, Yalcin S; Clevel and Clinic Sports Medicine*; Winalski C; Cleveland Clinic Sports Medicine group; Briskin I, Farrow LD, Jones MH, Miniaci AA, Parker RD, Rosneck JT, Saluan PM, Strnad GJ, Spindler KP. ACL tears are classified into three grades: Grade I ACL tears represent intraligamentous injury without a change in ligament length. 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). In this study, the time gap between injury and doing MRI was not considered. 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. Unauthorized use of these marks is strictly prohibited. This is a preview of subscription content, access via your institution. Posttraumatic Subchondral Bone Contusions and Fractures of the 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. Article Below is the link to the electronic supplementary material. Clin Radiol 2004;59:439-445. PubMed Central Eur J Orthop Surg Traumatol. There has been limited investigation to subdividing the bone contusion model in the medial and lateral directions of the tibial plateau and the . 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]. 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]. All the patients underwent magnetic resonance imaging (MRI) preoperatively, and the diagnosis was confirmed with the aid of arthroscopy. Texas Health Care Imaging is a radiology clinic located in Brownsville, TX. 2003;37:1379. At the time the case was submitted for publication Henry Knipe had no recorded disclosures. Deangelis JP, Spindler KP. Additionally, the program is designed to drive true consumer engagement with waived out of pocket expenses and no pre-certification, which allows patients fast and efficient access to providers for their imaging needs. Google Scholar, Berthold DP, Muench LN, Herbst E et al (2021) High prevalence of a deep lateral femoral notch sign in patients with anterior cruciate ligament (ACL) and concomitant posterior root tears of the lateral meniscus.
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