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Review Question - QID 7380

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QID 7380 (Type "7380" in App Search)
Which of the following physical examination findings is most likely present in the condition producing the MRI findings shown in Figure 92?
  • A

Valgus laxity at 30 degrees of knee flexion

3%

22/845

Varus laxity at 30 degrees of knee flexion

2%

17/845

Posterior drawer

9%

76/845

Pivot shift

76%

646/845

Patellar apprehension

9%

74/845

  • A

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The T2-weighted sagittal MRI scan shows the classic "bone bruise" pattern seen with an anterior cruciate ligament (ACL) tear. These lesions are thought to represent subcortical trabecular hemorrhages and are manifested as an increase in signal intensity on T2-weighted images and diminished signal intensity on T1-weighted images. They are classically located in the mid-portion of the lateral femoral condyle and posterior aspect of the lateral tibial plateau. This is due to the fact that an ACL tear typically is the result of a valgus-external rotation of the femur on the fixed tibia. This places most of the weight-bearing stress on the lateral femoral condyle, which rotates laterally and impacts the posterior lip of the lateral tibial plateau. This may result in an impaction fracture if the force is great enough, but more frequently causes merely a microfracture of the involved subcortical trabeculae.

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