sample radiology report for patient with acl tera

What is the role of MRI in the evaluation of ACL tears?

In such cases, MRI, by evaluating the extent of ACL signal abnormality and the presence of coexisting injuries, is effective in stratifying ACL tears into low-risk partial ACL tears versus high-risk partial or complete ACL tears.

What are the physical findings of a partial ACL tear?

The accepted physical examination findings of a partial ACL tear include: History of injury to the ACL. Positive Lachman or anterior drawer test with a firm endpoint. Negative pivot shift test. KT-1000 side to side difference of less than 5 mm.

What is the normal shape of the ACL in a MRI?

The ACL is normally seen as a longitudinally striated band, which parallels the intercondylar roof (6a) on slightly obliqued sagittal images. Close inspection of the axial (7a) and coronal views is also necessary for a thorough evaluation of the ACL.

Why is the posterolateral band of the ACL taut?

In extension, the posterolateral band becomes taut and the anteromedial band is lax (4a). This reciprocal tension pattern in flexion and extension allows the ACL to remain under tension and contribute to knee stability throughout the normal range of motion.

What is the clinical presentation of a patient with an ACL injury?

A loud pop or a "popping" sensation in the knee. Severe pain and inability to continue activity. Rapid swelling. Loss of range of motion.

What does a torn ACL xray look like?

X-rays will not show the ACL injury but will show if the injury involves any fractures. An MRI scan provides images of soft tissues such as torn ligaments. Usually, an MRI is not required for a torn ACL diagnosis.

How do you read an MRI for a torn ACL?

2:574:52How to Read Knee MRI of ACL Tear | Anterior Cruciate Ligament PainYouTubeStart of suggested clipEnd of suggested clipWithin the knotch. So normally we'd like to see it attached well within the confines of theMoreWithin the knotch. So normally we'd like to see it attached well within the confines of the intercondylar knotch as we look at the coronal views will start from anterior to posterior.

What imaging is best for ACL?

Magnetic resonance imaging (MRI). An MRI uses radio waves and a strong magnetic field to create images of both hard and soft tissues in your body. An MRI can show the extent of an ACL injury and signs of damage to other tissues in the knee, including the cartilage.

How do you assess an ACL injury?

Evaluation of the ACL should be performed immediately after an injury if possible, but is often limited by swelling and pain. When performed properly, a complete knee examination is more than 80 percent sensitive for an ACL injury. The Lachman test is the most accurate test for detecting an ACL tear.

Can you see a tear on an xray?

An X-ray won't show subtle bone injuries, soft tissue injuries or inflammation. However, even if your doctor suspects a soft tissue injury like a tendon tear, an X-ray might be ordered to rule out a fracture.

What is bright white on knee MRI?

A radiologist will review your knee MRI scans and give the results to your doctor. MRI images are black and white. Abnormalities may appear as bright white spots. These indicate areas where the contrast dye has collected due to enhanced cell activity.

How do you read a knee MRI picture?

0:528:41How to Read Knee MRI of Normal Knee | Minneapolis , MN - YouTubeYouTubeStart of suggested clipEnd of suggested clipGoes through the knee from front to back with the dimensions being medial to lateral in the knee. SoMoreGoes through the knee from front to back with the dimensions being medial to lateral in the knee. So when we first start out looking at coronal scan we can see the kneecap of the patella.

What kind of MRI is used for ACL tears?

ACL tear may only involve one bundle. Imaging signs of isolated posterolateral bundle tear are as follows: gap sign: fluid signal and/or a gap between the medial aspect of the lateral femoral condyle and the lateral aspect of the mid-ACL, can be seen on either axial or coronal MRI images.

Why is MRI best for ACL tear?

In summary, diagnosis of ACL injury using MRI has high accuracy and good consistency with arthroscopic diagnosis. It can provide reliable guidance for the selection and formulation of clinical surgery plans, and can be used as the first choice for the non-invasive diagnosis of ACL injury.

Will a CT show a torn ACL?

Computed tomography Although the ACL can be visualized on CT, its visibility is impaired in the presence of haemarthrosis and most patients with ACL injury are evaluated by MRI since this is also best for detecting concomitant menisceal, ligamentous or chondral injuries.

How accurate is MRI for ACL tear?

The sensitivity, specificity, and accuracy of MRI in the diagnosis of ACL injury were 95.45% (63/66), 91.67%, and 94.87%, respectively. The accuracy of MRI in the diagnosis of complete and partial tears were 92.86% and 94.74%, respectively.

Can you walk with a torn ACL?

Can you walk with a torn ACL? The short answer is yes. After the pain and swelling subsides and if there is no other injury to your knee, you may be able to walk in straight lines, go up and down stairs and even potentially jog in a straight line.

Can a torn ACL heal on its own in a dog?

Can a Dog Recover From an ACL Tear Without Getting Surgery? A torn ACL in dogs is one of the most common dog injuries. A torn ACL requires rest, immobilization, and sometimes surgery. It is entirely possible for a dog to recover from an ACL tear without surgery.

What test will show a torn ligament?

Imaging Tests Our doctors often use ultrasound to diagnose muscle, tendon, and ligament injuries because the imaging test can produce clearer picture of soft tissues. Doctors use MRI scan to examine the ligaments to determine the extent of a knee injury.

What is the ACL?

Biomechanics of the ACL. The anterior cruciate ligament is composed of densely organized fibrous collagenous connective tissue that attaches the femur to the tibia. The ACL is most commonly composed of two bands: the anteromedial and posterolateral.

What is the most common injury to the anteromedial band of the ACL?

Injury mechanisms are the same for partial tear and complete tear. The most common contact-related injury is the “clipping” type injury sustained in football. The knee is flexed, and with the foot planted, a valgus force is applied to the knee. Hyperextension injuries with or without varus can result in ACL disruption. Non-contact related injuries are increasingly recognized and are common in athletes involved in rapid deceleration with cutting, pivoting, or jumping.

What is the prognosis of a partial ACL tear?

The prognosis of a partial ACL tear is controversial and is dependent on the extent of the partial tear and associated meniscal, ligamentous, and osteochondral injuries. Small tears involving less than 25% of the ACL cross-section have a favorable prognosis of healing while maintaining stability of the knee.

What is the anteromedial band?

The anteromedial band is thickened and edematous (arrow). This represents a single bundle ACL, which is at high risk for functional ACL instability. The indirect signs of a partial ACL tear are the same as for a complete ACL tear, but are typically more subtle.

Why is MRI important for ACL?

MRI Findings. Because of its ability to depict anatomy in multiple planes and its non-invasiveness, MRI offers distinct advantages over arthroscopy as a means of evaluating the ACL. MRI evaluation is effective in preventing unnecessary arthroscopy by assessing the severity of the ACL tear and coexisting injuries. 4. 11.

Can partial ACL tear be MRI?

Partial tears of the ACL are a common injury. A significant percentage of partial tears will progress to a functionally complete ACL tear. MRI helps guide the treatment decision process by demonstrating the extent of the ACL injury and by demonstrating co-existing injuries of the ligaments, menisci, articular cartilage and capsule.

Pathology

Our primary goal is to evaluate for any pathology. When found, an immediate telephone call is made to the physician.

Personal Injury

In cases of trauma and personal injury, once fractures are excluded, we provide an extensive biomechanical assessment and correlate with symptoms when possible.

Anomalies

Developmental anomalies are common and in most cases are an incidental finding. Some anomalies may alter the type of patient care and treatment plans.

About Our DACBR

Dr. Doran L. Nicholson is a residency-trained, nationally recognized Chiropractic Radiologist. With over 30 years of experience, Dr. Nicholson takes pride in providing detailed, personalized reports for each interpretation.

Is the anterior bundle of the ulnar collateral ligament and lateral collateral ligament complex normal?

The anterior bundle of the ulnar collateral ligament and lateral collateral ligament complex are normal. The ulnar nerve, radial nerve, and median nerve at the elbow are unremarkable. No abnormality in the cubital tunnel region with dynamic imaging.

Is the medial collateral ligament normal?

The medial and lateral collateral ligaments are normal, as is the iliotibial tract, biceps femoris, popliteus tendon, and common peroneal nerve. There is medial compartment joint space narrowing and osteophyte formation with mild extrusion of the body of the medial meniscus, which is abnormally hypoechoic.

Is the anterior margin of the tear adjacent to the rotator?

The anterior margin of the tear is adjacent to the rotator interval. There is no involvement of the subscapularis, infraspinatus, or rotator interval. A moderate amount of infraspinatus and supraspinatus fatty degeneration is present.

Diagnosis

Introduction

Biomechanics of The ACL

Mechanism of Injury

Physical Examination

• The accepted physical examination findings of a partial ACL tear include: 1. History of injury to the ACL 2. Positive Lachman or anterior drawer test with a firm endpoint 3. Negative pivot shift test 4. KT-1000 side to side difference of less than 5 mm. However the accurate detection of partial ACL tears by physical exam is limited by several facto...

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MRI Technique

MRI Findings

Treatment

Conclusion

References