kissing contusion knee radiology
The site is secure. AJR Am J Roentgenol. Google Scholar. -, Acta Orthop Scand. Bone contusion of knee: Increase lesion detection with fast spin echo MR Imaging with spectroscopic Fat saturation. Contusions of both surfaces of the knee joint are known as kissing contusions. Grade II ACL tears represent intraligamentous injury and an increase in ligament length. Skeletal Radiology Among the 200 cases, bone marrow contusion was noted in 138 cases (69%) and absent contusion in 62 cases (31%). The 32 bone contusions (16 kissing contusions) were located as follows: lateral femoral condyle (n = 14; 8 type I, 6 type II); lateral tibial condyle (n = 9; 3 type I, 1 type II, 5 type III);. HW contributed to some imaging data and surgery. Our Facilities. MRI of the Pediatric Knee Pediatric Imaging Review. AJR Am J Roentgenol. 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. It can also damage interposed soft tissues, most commonly the articular cartilage and meniscus. N Z Med J. Conclusions: Following knee hyperextension, bone bruising patterns may be associated with cruciate ligament injury. 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]. 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. Twenty of the 23 patients had follow-up imaging. The .gov means its official. Therefore, an influence by the number of bone bruises on healing time was marked; the higher the number, the more likely that there will be one slowly resolving lesion. Bethesda, MD 20894, Web Policies The saggital plane was primarily used to evaluate the bone marrow oedema which was confirmed on coronal images. Correspondence to To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint. We describe the clinical and radiographic features of 11 athletes found to have femoral head lesions similar in MR imaging appearance to osteochondral lesions in other locations, such as the knee and ankle. Comparison of bone contusion seen by MRI in partial and complete tears of the anterior cruciate ligament. A knee contusion can range from mild to severe. MRI is used widespread to interpret more complex injuries. 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]. Home; Service. of knee injury in pediatric patients. In this study, inclusion criteria were acute knee injury only in athletes while in our study there were no such selection criteria. JB JS Open Access. Epub 2022 Apr 12. At the time the article was last revised Joshua Yap had Part of Springer Nature. MRI follow-up of posttraumatic bone bruises of the knee in general practice. PubMedGoogle Scholar. Clipboard, Search History, and several other advanced features are temporarily unavailable. Check for errors and try again. KIS Imaging is the nations largest direct contracting imaging network with over 2,600 providers covering all major imaging needs: MRI, CT and PET. As a library, NLM provides access to scientific literature. Keywords: Br J Sports Med 42(6):394412, Saxena A, Ray B, Rajagopal K, DSouza A, Pyrtuh S (2012) Morphometry and magnetic resonance imaging of anterior cruciate ligament and measurement of secondary signs of anterior cruciate ligament tear. No cost for the Employer or Employee with up to 80% savings. Magnetic resonance imaging of bone bruising in the acutely injured kneeshort-term outcome. Am J Sports Med. Epub 2021 Apr 4. 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. 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. These contusions are generally found by magnetic resonance imaging and most cases are associated with ligamentous or menisceal injuries.[1]. Bone contusion and associated meniscal and medial collateral ligament injury in patients with anterior cruciate ligament rupture. 31 0 obj Call Us Today! In many cases, Bone marrow contusion might have resolved at time of MRI. CAS HHS Vulnerability Disclosure, Help Fornalski S, McGarry MH, Csintalan RP, Fithian DC, Lee TQ. {"url":"/signup-modal-props.json?lang=us"}, Knipe H, Yap J, Al Kabbani A, et al. The magnitude of the force is a major determinant of the imaging findings. endobj Patterns of bone bruise in knee injury. 1 0 obj Bone marrow bruise is ill defined subchondral reticular or stellate region of low signal intensity on T1 and high signal intensity on T2W images [6]. Bone marrow contusion usually resolves in 6-8 weeks [6]. 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. 1. Hyperextension of the knee can result when direct force is applied to the anterior tibia while the foot is planted or from an indirect force, such as a forceful kicking. Other associated injury in ACL (87.5%), Medial meniscus (50 %) and lateral meniscus (75%). 2014 . The https:// ensures that you are connecting to the 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. Bone marrow contusions are frequently identified at magnetic resonance imaging after an injury to the musculoskeletal system, and the mechanism of injury can be determined by studying the distribution of bone marrow edema, which enables one to predict with accuracy the specific soft-tissue abnormalities that are likely to be present. Federal government websites often end in .gov or .mil. E-mail: Received 2016 Jan 13; Revisions requested 2016 Jan 29; Accepted 2016 Feb 28. 2023 Springer Nature Switzerland AG. Epub 2021 May 11. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). MeSH Eur J Radiol. Kessler R, Campbell S, Wong D, Mansfield LB. At the time the case was submitted for publication Henry Knipe had no recorded disclosures. Department of Radiology, Wilford Hall Medical Center, 759th MDTS/MTRD, 2200 Bergquist Dr, Ste 1, Lackland AFB, TX 78236-5300, USA. Clin Radiol 2004;59:439-445. The knee is a major weight bearing joint that provides mobility and stability during physical activity as well as balance while standing. Am J Sports Med. Five classic bone contusion patterns have been described 1-4: The knee is a complex synovial joint that can be affected by a range of pathologies: Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. endobj 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. Kapelov SR, Teresi LM, Bradley WG, Bucciarelli NR, Murakami DM, Mullin WJ, et al. Case Discussion. Grade 1 refers to the uniform-ly low normal meniscal signal, grade 2 de-scribes increased signal within the meniscus . Bone marrow oedema is responsible for patient symptoms and may lead to early degenerative changes [7]. Bone Bruise Distribution Patterns After Acute Anterior Cruciate Ligament Ruptures: Implications for the Injury Mechanism. PDFS Saggital: Bone marrow oedema at Lateral femoral and posterolateral tibial plateau in Pivot shift injury. Follow-up of occult bone lesions detected at MR imaging: systematic review. 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. Following knee hyperextension, bone bruising patterns may be associated with cruciate ligament injury. This is a preview of subscription content, access via your institution. Bookshelf PubMed PDFS Saggital: Bone marrow oedema in Intercondylar region tibia with subchondral cysts. Br J Sports Med. Bone marrow contusions are frequently identified at magnetic . Am J Sports Med. endobj In current study unclassifiable injuries pattern was noted in 6 cases. PMC [12] Deangelis JP, Spindler KP. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. <> Kim SY, Spritzer CE, Utturkar GM, Toth AP, Garrett WE, DeFrate LE. 1999;211:74753. Hayes CW, Brigido MK, Jamadar DA, Propeck Tim. 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. A. M. Ali. J Bone Joint Surg Am 92(2):353360, Yu JS, Bosch E, Pathria MN et al (1995) The deep lateral femoral sulcus:correlation in 124 patients with anterior cruciate ligament tear. A prospective study of the association between bone contusion and intra-articular injuries associated with acute anterior cruciate ligament tear. Pivot shift injury pattern according to Location of marrow oedema. MRI follow-up of posttraumatic bone bruises of the knee in general practice. Arndt WA, Traux AL, Baranett FM, Simmon GE, Brown DC. Sanders TG, Medynski MA, Feller JF, Lawhorn KW. Bone contusion and associated meniscal and medial collateral ligament injury in patients with anterior cruciate ligament rupture. sharing sensitive information, make sure youre on a federal Bone marrow contusion showed five patterns (according to Sanders classification) i.e., Clip injury in 39 cases (28.3%), Pivot shift injury in 78 cases (56.5%), Dashboard injury in eight cases (5.8%), Hyperextension injury in four cases (2.9%), Lateral patellar dislocation in three cases (2.2%). doi: 10.2106/JBJS.OA.21.00069. eCollection 2022 Oct. Moran J, Katz LD, Schneble CA, Li D, Kahan JB, Wang A, Porrino J, Jokl P, Hewett TE, Medvecky MJ. 2000;24:37180. PubMed Central Radiology. bone bruises on magnetic resonance imaging evaluation of anterior cruciate ligament injuries. no significant difference in location for different type/ mode of injury. PubMed A deeper notch often indicates a more complex knee injury. Mild high signal of the distal semimembranosus insertion, however, the remaining posteromedial corner structures appear uninjured. It typically occurs in teenagers and young adults involved in athletic activities. Pattern of marrow oedema as per classification. endstream %PDF-1.4 % Bone bruises: MR characteristics and histological correlation in the young pig. The site is secure. Furthermore, it is anterior tibial oedema rather than the presence of kissing lesions than predicts cruciate ligament injury (OR = 10.5, p = 0.02). Conclusions: Arch Orthop Trauma Surg 143, 927934 (2023). 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. We have included all the patients coming with acute knee injuries irrespective of type/mode of injury. Knee Surg Sports Traumatol Arthrosc. Kirsch MD, Fitzgerald SW, Friedman H, Rogers LF. Correlation between type or mode of injury and patterns of bone marrow oedema was determined using p-value and chi-square method. The usefulness of the oblique coronal plane in knee MRI on the evaluation of the posterior cruciate ligament. Hong CK, Lin YJ, Cheng TA, Chang CH, Hsu KL, Kuan FC, Su WR. Transient lateral patellar dislocation: diagnosis with MR imaging. PDFS Coronal: Bone marrow oedema at Medial femoral condyle and Metadiaphysis. Knee Surg Sports Traumatol Arthrosc 29(6):19681976, Egloff C, Huber L, Wurm M, Pagenstert G (2019) No added value using SPECT/CT to analyze persistent symptoms after anterior cruciate ligament reconstruction. 1989 Mar;170(3 Pt 1):823-9 Zeiss J, Paley K, Murray K, Saddemi SR. Please enable it to take advantage of the complete set of features! An official website of the United States government. 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. 2003;37:1379. Right knee injury was noted in 87 cases (63%) and left knee in 51 cases (37%). <> Diagnostic value of the lateral femoral notch sign and kissing contusion in patients with anterior cruciate ligament injuries: a case-control study. Inclusion criteria were patients with recent knee injuries (<6weeks) and normal plain radiograph with no signs of pathology. and kissing contusions of the lat-eral femoral condyle and medial tibial pla . endobj Magnetic Resonance Imaging of Sports injuries of knee. The lateral femoral notch sign (LFNS) and the kissing contusion (KC) are two indirect signs of anterior cruciate ligament (ACL) injuries. 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]. While the knee is in a state of flexion, twisting motion of the knee can lead to transient dislocation of knee. Contusions of both surfaces of the joint are known as kissing contusions. Hong CK, Hoshino Y, Watanabe S, Nagai K, Matsushita T, Su WR, Kuroda R. Knee Surg Sports Traumatol Arthrosc. The clip injury results in a prominent area of edema involving the lateral femoral condyle and a smaller area of edema involving the medial femoral condyle. Acta Orthop Traumatol Turc. J Bone Joint Surg Am. No significant difference was noted in location of bone marrow contusion in clip injury for different type/mode of injury. 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. According to study conducted by Terzidis et al., Kissing contusion in acute knee injury is noted in 16 cases out of 225 (7.1%). application/pdf The associated injuries were confirmed by arthroscopy in 12/16 patients. Davies NH, Niall D, King LJ, Lavelle J, Healy JC. In our study pivot shift pattern is noted in 78 cases (56.5%). Anterior cruciate, and medial and lateral collateral ligaments are intact. PubMed Tensile load can cause ligament and tendon tears as well as avulsion fracture. Clinical outcome of isolated subcortical trabecular fractures (bone bruise) detected on magnetic resonance imaging in knees. official website and that any information you provide is encrypted 1030). PubMedGoogle Scholar. Google Scholar. The site is secure. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). sharing sensitive information, make sure youre on a federal The presence of a double sulcus showed significant association with anteromedial kissing contusions (OR=7.8, p=0.03). This site needs JavaScript to work properly. Radiology 193(3):835840, Grimberg A, Shirazian H, Torshizy H, Smitaman E, Chang EY, Resnick DL (2015) Deep lateral notch sign and double notch sign in complete tears of the anterior cruciate ligament: MR imaging evaluation. 1993 Mar-Apr;21(2):220-3 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]. . Clin Orthop Relat Res. The presence of a double sulcus showed significant association with anteromedial kissing contusions (OR = 7.8, p = 0.03). -, Radiology. Bone contusion patterns of the knee at MR imaging: footprint of the mechanism of injury. Bone marrow oedema of the knee may cause substantial clinical entities, as they cause acute pain and functional loss in the joint. Emerg Radiol 2:129134, Article Acta Radiol. PubMed A 124(62%) had trauma in right knee and 76(38%) in left knee. On applying fisher-exact test, p = 0.1655 i.e. Kissing contusion refers to the bone contusions in both femoral and tibial surfaces of the knee. 99 0 obj In this study, patients with history of knee injury <6 weeks were considered as recent knee injuries. Am J Sports Med. 2007;189:55662. A thorough understanding of knee injury patterns and their mechanisms may help in achieving more accurate assessment of injuries. Our team of experienced agents will hand hold the member through theentireprocess. Although patients often present to the emergency department with acute knee pain and hemarthrosis, spontaneous reduction frequently occurs, and half of cases are unsuspected clinically. Associated Soft tissue injuries include ACL and medial meniscus [8]. <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/TrimBox[57.25999 58.11 666.34 848.69299]/Type/Page>> Incidence and location of bone bruises after acute posterior cruciate ligament injury. PubMed Bisson LJ, Kluczynski MA, Hagstrom LS, Marzo JM. "Kissing contusion" refers to a bone contusion on both side of the knee joint. Chi-square = 1.926, p =0.3817 i.e. Bookshelf To establish whether patterns of soft tissue injury following knee hyperextension are associated with post-traumatic bone bruise distribution. 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]. Assessment with magnetic resonance, correlated with arthroscopy. 2023-05-01T23:01:26-07:00 Traumatic Bone Bruises in the Athlete's Knee. Informed consent was obtained from the patients in English or regional language. The most common sites of bone bruising were the anteromedial tibial plateau (48%) and anterolateral tibial plateau (44%). An axial acquisition through the patella femoral joint was used as the initial localizer for subsequent coronal and saggital images. eCollection 2021 Oct-Dec. Liu ZY, Zhang JL, Zhang T, Cao Q, Zhao JC, Li EQ, Shen QJ, Zhao BC, Zheng YC, Chen Y. Orthop Surg. 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. Epub 2013 Jun 6. Lim YS, Peh WC. J Orthop Surg Res. Bone bruise of the knee: histology and cryosections in 5 cases. Common entities include acute traumatic osteochondral injuries, subchondral insufficiency fracture, so-called spontaneous osteonecrosis of the knee, avascular necrosis, osteochondritis dissecans, and localized osteochondral abnormalities in osteoarthritis. Popular works include The appearance of kissing contusion in the acutely injured knee in the athletes, Role of Magnetic Resonance Imaging in Study of the Patellofemoral Joint Morphological Abnormalities Predisposing to Patellar Instability and more. National Library of Medicine A knee contusion can usually be treated . After knee injury, bone marrow oedema is frequently subchondral in location and may be associated with either trabecular or cortically based lines [4]. Thank Professor Zhuozhao Zheng and my girlfriend Danyu Chen for their advice and help on this study. You can help Wikipedia by expanding it. Learn more about Institutional subscriptions. 1996 Sep;(330):133-42 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. Bone marrow contusion was noted in lateral femoral condyle in 15 cases (38.5%) and involving lateral and medial femoral condyle in 24 cases (61.5%). Bone contusion of the posterior lip of the medial tibial plateau (contrecoup injury) and associated internal derangements of the knee. In this study 8 cases (5.7%) had dashboard injury pattern of bone marrow contusion at anterior aspect of proximal tibia. Check for errors and try again. 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. The https:// ensures that you are connecting to the and transmitted securely. Our imaging services center is on the 1st floor of the hospital, directly behind our main reception area. Knee kinematics during noncontact anterior cruciate ligament injury as determined from bone bruise location.
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