Tears in the distal superficial medial collateral ligament: the wave sign and other associated MRI findings
Objective To analyze the MRI characteristics of distal superficial medial collateral ligament (sMCL) tears and to identify features of tears displaced superficial to the pes anserinus (Stener-like lesion (SLL)). Materials and methods Knee MRI examinations at four institutions were selected which sho...
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| Veröffentlicht in: | Skeletal radiology 2020-05, Vol.49 (5), p.747-756 |
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| creator | Boutin, Robert D. Fritz, Russell C. Walker, Richard E. A. Pathria, Mini N. Marder, Richard A. Yao, Lawrence |
| description | Objective
To analyze the MRI characteristics of distal superficial medial collateral ligament (sMCL) tears and to identify features of tears displaced superficial to the pes anserinus (Stener-like lesion (SLL)).
Materials and methods
Knee MRI examinations at four institutions were selected which showed tears of the sMCL located distal to the joint line. MRIs were evaluated for a SLL, a wavy contour to the sMCL, and the location of the proximal sMCL stump. Additional coexistent knee injuries were recorded.
Results
The study included 51 patients (mean age, 28 years [sd, 12]). A SLL was identified in 20 of 51 cases. The proximal stump margin was located significantly (
p
< 0.01) more distal and more medial with a SLL (mean = 33 mm [sd = 11 mm] and mean = 6.5 mm [sd = 2.5 mm], respectively), than without a SLL (mean = 19 mm [sd = 16 mm] and mean = 4.8 mm [sd = 2.4 mm], respectively). Medial compartment osseous injury was significantly (
p
< 0.05) more common with a SLL (75%) than without a SLL (42%). The frequency of concomitant injuries in the group (ACL tear, 82%; PCL tear, 22%; deep MCL tear, 61%; lateral compartment osseous injury, 94%) did not differ significantly between patients with and without a SLL.
Conclusion
A distal sMCL tear should be considered when MRI depicts a wavy appearance of the sMCL. Distal sMCL tears have a frequent association with concomitant knee injuries, especially ACL tears and lateral femorotibial osseous injuries. A SLL is particularly important to recognize because of implications for treatment. |
| doi_str_mv | 10.1007/s00256-019-03352-4 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2323468013</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A731359824</galeid><sourcerecordid>A731359824</sourcerecordid><originalsourceid>FETCH-LOGICAL-c442t-f9cd97ea6510443dae00ab05677dae81d4264f90f50f135676a097bacb21310b3</originalsourceid><addsrcrecordid>eNp9kUtv1TAQhS0EopfCH2CBLLFhkzJ-xE7YVRWPSkVIqKwtJxkHl1znYieg_vvO7S1UIIS88Gj8ndEZH8aeCzgRAPZ1AZC1qUC0FShVy0o_YBuhlaykMOIh24AyupJKN0fsSSlXAMLa2jxmR0o0EkDrDft2iT4XHhNfviIfYln8xMu6wxxiH6ne4rC_-nma_IKZyimOfotpeXMr-el_IC9xTNyngc_UytyXMpN4wYF__HzOQ0xDTGN5yh4FPxV8dncfsy_v3l6efaguPr0_Pzu9qHqt5VKFth9ai97UgiyqwSOA76A21lLdiEFLo0MLoYYgFLWNh9Z2vu-kUAI6dcxeHebu8vx9xbK4bSw90gIJ57U4qehPTANCEfryL_RqXnMid0TZtm2sUuaeGv2ELqYwL9n3-6Hu1Cry0DZSE3XyD4rOgNvYzwlDpP4fAnkQ9HkuJWNwuxy3Pl87AW6fsDsk7Chhd5uw24te3DleO8rmt-RXpASoA1DoKY2Y71f6z9gbkAOulg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2379987336</pqid></control><display><type>article</type><title>Tears in the distal superficial medial collateral ligament: the wave sign and other associated MRI findings</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Boutin, Robert D. ; Fritz, Russell C. ; Walker, Richard E. A. ; Pathria, Mini N. ; Marder, Richard A. ; Yao, Lawrence</creator><creatorcontrib>Boutin, Robert D. ; Fritz, Russell C. ; Walker, Richard E. A. ; Pathria, Mini N. ; Marder, Richard A. ; Yao, Lawrence</creatorcontrib><description>Objective
To analyze the MRI characteristics of distal superficial medial collateral ligament (sMCL) tears and to identify features of tears displaced superficial to the pes anserinus (Stener-like lesion (SLL)).
Materials and methods
Knee MRI examinations at four institutions were selected which showed tears of the sMCL located distal to the joint line. MRIs were evaluated for a SLL, a wavy contour to the sMCL, and the location of the proximal sMCL stump. Additional coexistent knee injuries were recorded.
Results
The study included 51 patients (mean age, 28 years [sd, 12]). A SLL was identified in 20 of 51 cases. The proximal stump margin was located significantly (
p
< 0.01) more distal and more medial with a SLL (mean = 33 mm [sd = 11 mm] and mean = 6.5 mm [sd = 2.5 mm], respectively), than without a SLL (mean = 19 mm [sd = 16 mm] and mean = 4.8 mm [sd = 2.4 mm], respectively). Medial compartment osseous injury was significantly (
p
< 0.05) more common with a SLL (75%) than without a SLL (42%). The frequency of concomitant injuries in the group (ACL tear, 82%; PCL tear, 22%; deep MCL tear, 61%; lateral compartment osseous injury, 94%) did not differ significantly between patients with and without a SLL.
Conclusion
A distal sMCL tear should be considered when MRI depicts a wavy appearance of the sMCL. Distal sMCL tears have a frequent association with concomitant knee injuries, especially ACL tears and lateral femorotibial osseous injuries. A SLL is particularly important to recognize because of implications for treatment.</description><identifier>ISSN: 0364-2348</identifier><identifier>EISSN: 1432-2161</identifier><identifier>DOI: 10.1007/s00256-019-03352-4</identifier><identifier>PMID: 31820044</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Anterior cruciate ligament ; Female ; Humans ; Imaging ; Injuries ; Knee ; Knee Injuries - diagnostic imaging ; Ligaments ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Male ; Medial Collateral Ligament, Knee - diagnostic imaging ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Middle Aged ; Nuclear Medicine ; Orthopedics ; Pathology ; Radiology ; Scientific Article ; Tearing ; Young Adult</subject><ispartof>Skeletal radiology, 2020-05, Vol.49 (5), p.747-756</ispartof><rights>ISS 2019</rights><rights>COPYRIGHT 2020 Springer</rights><rights>Skeletal Radiology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-f9cd97ea6510443dae00ab05677dae81d4264f90f50f135676a097bacb21310b3</citedby><cites>FETCH-LOGICAL-c442t-f9cd97ea6510443dae00ab05677dae81d4264f90f50f135676a097bacb21310b3</cites><orcidid>0000-0001-7887-9658</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00256-019-03352-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00256-019-03352-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31820044$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Boutin, Robert D.</creatorcontrib><creatorcontrib>Fritz, Russell C.</creatorcontrib><creatorcontrib>Walker, Richard E. A.</creatorcontrib><creatorcontrib>Pathria, Mini N.</creatorcontrib><creatorcontrib>Marder, Richard A.</creatorcontrib><creatorcontrib>Yao, Lawrence</creatorcontrib><title>Tears in the distal superficial medial collateral ligament: the wave sign and other associated MRI findings</title><title>Skeletal radiology</title><addtitle>Skeletal Radiol</addtitle><addtitle>Skeletal Radiol</addtitle><description>Objective
To analyze the MRI characteristics of distal superficial medial collateral ligament (sMCL) tears and to identify features of tears displaced superficial to the pes anserinus (Stener-like lesion (SLL)).
Materials and methods
Knee MRI examinations at four institutions were selected which showed tears of the sMCL located distal to the joint line. MRIs were evaluated for a SLL, a wavy contour to the sMCL, and the location of the proximal sMCL stump. Additional coexistent knee injuries were recorded.
Results
The study included 51 patients (mean age, 28 years [sd, 12]). A SLL was identified in 20 of 51 cases. The proximal stump margin was located significantly (
p
< 0.01) more distal and more medial with a SLL (mean = 33 mm [sd = 11 mm] and mean = 6.5 mm [sd = 2.5 mm], respectively), than without a SLL (mean = 19 mm [sd = 16 mm] and mean = 4.8 mm [sd = 2.4 mm], respectively). Medial compartment osseous injury was significantly (
p
< 0.05) more common with a SLL (75%) than without a SLL (42%). The frequency of concomitant injuries in the group (ACL tear, 82%; PCL tear, 22%; deep MCL tear, 61%; lateral compartment osseous injury, 94%) did not differ significantly between patients with and without a SLL.
Conclusion
A distal sMCL tear should be considered when MRI depicts a wavy appearance of the sMCL. Distal sMCL tears have a frequent association with concomitant knee injuries, especially ACL tears and lateral femorotibial osseous injuries. A SLL is particularly important to recognize because of implications for treatment.</description><subject>Adult</subject><subject>Anterior cruciate ligament</subject><subject>Female</subject><subject>Humans</subject><subject>Imaging</subject><subject>Injuries</subject><subject>Knee</subject><subject>Knee Injuries - diagnostic imaging</subject><subject>Ligaments</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Medial Collateral Ligament, Knee - diagnostic imaging</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Middle Aged</subject><subject>Nuclear Medicine</subject><subject>Orthopedics</subject><subject>Pathology</subject><subject>Radiology</subject><subject>Scientific Article</subject><subject>Tearing</subject><subject>Young Adult</subject><issn>0364-2348</issn><issn>1432-2161</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kUtv1TAQhS0EopfCH2CBLLFhkzJ-xE7YVRWPSkVIqKwtJxkHl1znYieg_vvO7S1UIIS88Gj8ndEZH8aeCzgRAPZ1AZC1qUC0FShVy0o_YBuhlaykMOIh24AyupJKN0fsSSlXAMLa2jxmR0o0EkDrDft2iT4XHhNfviIfYln8xMu6wxxiH6ne4rC_-nma_IKZyimOfotpeXMr-el_IC9xTNyngc_UytyXMpN4wYF__HzOQ0xDTGN5yh4FPxV8dncfsy_v3l6efaguPr0_Pzu9qHqt5VKFth9ai97UgiyqwSOA76A21lLdiEFLo0MLoYYgFLWNh9Z2vu-kUAI6dcxeHebu8vx9xbK4bSw90gIJ57U4qehPTANCEfryL_RqXnMid0TZtm2sUuaeGv2ELqYwL9n3-6Hu1Cry0DZSE3XyD4rOgNvYzwlDpP4fAnkQ9HkuJWNwuxy3Pl87AW6fsDsk7Chhd5uw24te3DleO8rmt-RXpASoA1DoKY2Y71f6z9gbkAOulg</recordid><startdate>20200501</startdate><enddate>20200501</enddate><creator>Boutin, Robert D.</creator><creator>Fritz, Russell C.</creator><creator>Walker, Richard E. A.</creator><creator>Pathria, Mini N.</creator><creator>Marder, Richard A.</creator><creator>Yao, Lawrence</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7887-9658</orcidid></search><sort><creationdate>20200501</creationdate><title>Tears in the distal superficial medial collateral ligament: the wave sign and other associated MRI findings</title><author>Boutin, Robert D. ; Fritz, Russell C. ; Walker, Richard E. A. ; Pathria, Mini N. ; Marder, Richard A. ; Yao, Lawrence</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-f9cd97ea6510443dae00ab05677dae81d4264f90f50f135676a097bacb21310b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Anterior cruciate ligament</topic><topic>Female</topic><topic>Humans</topic><topic>Imaging</topic><topic>Injuries</topic><topic>Knee</topic><topic>Knee Injuries - diagnostic imaging</topic><topic>Ligaments</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Medial Collateral Ligament, Knee - diagnostic imaging</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Middle Aged</topic><topic>Nuclear Medicine</topic><topic>Orthopedics</topic><topic>Pathology</topic><topic>Radiology</topic><topic>Scientific Article</topic><topic>Tearing</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Boutin, Robert D.</creatorcontrib><creatorcontrib>Fritz, Russell C.</creatorcontrib><creatorcontrib>Walker, Richard E. A.</creatorcontrib><creatorcontrib>Pathria, Mini N.</creatorcontrib><creatorcontrib>Marder, Richard A.</creatorcontrib><creatorcontrib>Yao, Lawrence</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection (ProQuest)</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Skeletal radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Boutin, Robert D.</au><au>Fritz, Russell C.</au><au>Walker, Richard E. A.</au><au>Pathria, Mini N.</au><au>Marder, Richard A.</au><au>Yao, Lawrence</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tears in the distal superficial medial collateral ligament: the wave sign and other associated MRI findings</atitle><jtitle>Skeletal radiology</jtitle><stitle>Skeletal Radiol</stitle><addtitle>Skeletal Radiol</addtitle><date>2020-05-01</date><risdate>2020</risdate><volume>49</volume><issue>5</issue><spage>747</spage><epage>756</epage><pages>747-756</pages><issn>0364-2348</issn><eissn>1432-2161</eissn><abstract>Objective
To analyze the MRI characteristics of distal superficial medial collateral ligament (sMCL) tears and to identify features of tears displaced superficial to the pes anserinus (Stener-like lesion (SLL)).
Materials and methods
Knee MRI examinations at four institutions were selected which showed tears of the sMCL located distal to the joint line. MRIs were evaluated for a SLL, a wavy contour to the sMCL, and the location of the proximal sMCL stump. Additional coexistent knee injuries were recorded.
Results
The study included 51 patients (mean age, 28 years [sd, 12]). A SLL was identified in 20 of 51 cases. The proximal stump margin was located significantly (
p
< 0.01) more distal and more medial with a SLL (mean = 33 mm [sd = 11 mm] and mean = 6.5 mm [sd = 2.5 mm], respectively), than without a SLL (mean = 19 mm [sd = 16 mm] and mean = 4.8 mm [sd = 2.4 mm], respectively). Medial compartment osseous injury was significantly (
p
< 0.05) more common with a SLL (75%) than without a SLL (42%). The frequency of concomitant injuries in the group (ACL tear, 82%; PCL tear, 22%; deep MCL tear, 61%; lateral compartment osseous injury, 94%) did not differ significantly between patients with and without a SLL.
Conclusion
A distal sMCL tear should be considered when MRI depicts a wavy appearance of the sMCL. Distal sMCL tears have a frequent association with concomitant knee injuries, especially ACL tears and lateral femorotibial osseous injuries. A SLL is particularly important to recognize because of implications for treatment.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31820044</pmid><doi>10.1007/s00256-019-03352-4</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-7887-9658</orcidid></addata></record> |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Adult Anterior cruciate ligament Female Humans Imaging Injuries Knee Knee Injuries - diagnostic imaging Ligaments Magnetic resonance imaging Magnetic Resonance Imaging - methods Male Medial Collateral Ligament, Knee - diagnostic imaging Medical research Medicine Medicine & Public Health Medicine, Experimental Middle Aged Nuclear Medicine Orthopedics Pathology Radiology Scientific Article Tearing Young Adult |
| title | Tears in the distal superficial medial collateral ligament: the wave sign and other associated MRI findings |
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