Learning objectives
1. Imaging related case based diagnostic interpretation to Posterolateral corner injury (PLC)
2. Pictorial representation of plain radiographic, CT and MR examples of PLC injury.
3. Compare imaging findings with intra-operative findings at time of orthopaedic intervention.
Background
BACKGROUND:
Identifying the pattern of injury for underlying knee joint intenal derangment in the setting of trauma or degenerative change is important for patient management. One entity seen in the trauma setting is Posterolateral corner injury (PLC) of the knee which may predispose to instability and long term dysfunction if not accurately diagnosed.1The PLC provides the knee with stabalization during tibial external rotation during knee flexion. Imaging, particularly MRI, is vital in assessing the structures of the posterolateral corner and conventional 3T MRI in recent...
Imaging findings OR Procedure details
Patient 1: A 28 year-old male patient presenting to the emergency department with a swollen knee with inability to weightbear following a high axial load injury whilst playing a soccer competition. Clinical examination by the emergency team demonstrated a markedly swollen right knee which was neurovacularly intact at time of clinical assessment. There was concern of knee joint (tibiofemoral) dislocation at time of history taking. On examination, the patient was globally tender over the knee with more tenderness along the lateral joint line. The patient...
Conclusion
Posterolateral corner injuries are a complex entity of knee internal derangment that present most commonly in the setting of high axial load/valgus stress during hyperextension of the knee. Important structures include the PCL ACL, popliteus tendon, lateral collateral ligaments and the arcuate ligamentous complex.4 Discrete anatomical delineation with multisequential MR is an important tool to identify the structures involved and provide important prognositic and anatomical delineation in opearative management of these injuries. A combination of robust clinical assessment, appropriate imaging ordering and high degree of...
References
aPrade, Robert F.Posterolateral Knee Injuries Anatomy, Evaluation, and Treatment. Chapter 1: Introduction and Incidence of Posterolateral Knee Injuries. Thieme, 2006
LaPrade, Robert F.Posterolateral Knee Injuries Anatomy, Evaluation, and Treatment. Chapter 4: Mechanism and Presenting History of Posterolateral Knee Injuries. Thieme, 2006.
LaPrade, R. F., Wentorf, F. A., Fritts, H., Gundry, C., & Hightower, C. D. (2007). A prospective magnetic resonance imaging study of the incidence of posterolateral and multiple ligament injuries in acute knee injuries presenting with a hemarthrosis.Arthroscopy: The Journal of Arthroscopic & Related...