+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

MR diagnosis of complete tears of the anterior cruciate ligament of the knee: importance of anterior subluxation of the tibia

, : MR diagnosis of complete tears of the anterior cruciate ligament of the knee: importance of anterior subluxation of the tibia. Ajr. American Journal of Roentgenology 162(2): 355-360

OBJECTIVE. The primary role of the anterior cruciate ligament is to resist anterior subluxation of the tibia. When the ligament is torn, the tibia is free to sublux anteriorly when the leg is pulled forward. In addition to visualizing the anterior cruciate ligament directly, MR imaging can show joint alignment. The purpose of this study was to test the efficacy of MR images of anterior subluxation of the tibia for diagnosing complete tears of the anterior cruciate ligament. MATERIALS AND METHODS. We evaluated the records of 120 consecutive patients who underwent MR imaging of the knee and subsequently had arthroscopy. Arthroscopy showed a complete tear of the anterior cruciate ligament in 21 patients, a partial tear in eight patients, and an intact anterior cruciate ligament in 91 patients. Two radiologists together reviewed the MR images, and interpretation of anterior cruciate ligament integrity was reached by consensus. The anterior cruciate ligament was categorized as intact, completely torn, or partially torn on the basis of conventional MR imaging criteria. The degree of anterior subluxation of the tibia was measured on a separate occasion in random order by a radiologist who used a sagittal section through the middle of the lateral femoral condyle. On the selected image, two vertical lines parallel to the left and right margins of the image frame were drawn tangent to the posterior cortical margins of the lateral femoral and tibial condyles. Anterior subluxation of the tibia was determined by the distance in millimeters between these two lines and measured with calipers by using the 5-cm scale on the images. Measurements were considered reliable only to one half of the smallest increment of this scale (i.e., 5 mm). Accordingly, tibial subluxation (x) was measured in 5-mm increments, with times ltoreq 0 mm designated grade 0, 0 mm lt times ltoreq 5 mm designated grade 1, 5 mm lt times ltoreq 10 mm designated grade 2, and so forth. RESULTS. Conventional MR imaging criteria had 90% sensitivity and 94% specificity for diagnosing complete tears of the anterior cruciate ligament. According to the receiver-operating-characteristic (ROC) curve, anterior subluxation of the tibia greater than 5 mm (grade 2 or greater) was considered to be the optimal threshold (sensitivity, 86%; specificity, 99%) for diagnosing complete tears of the anterior cruciate ligament. Notably, none of the six false-positive diagnoses of complete tears by conventional criteria (three partial tears and three intact ligaments at arthroscopy) were misdiagnosed when tibial subluxation was used as the diagnostic criterion. Subluxation greater than 5 mm can be falsely negative with chronic tears of the anterior cruciate ligament (n = 2) or when a displaced bucket-handle tear of the lateral meniscus blocks anterior subluxation of the tibia (n = 1). CONCLUSION. An anterior tibial subluxation greater than 5 mm (grade 2 or greater) is a simple objective measurement that serves as a helpful adjunctive sign in the diagnosis of complete tears of the anterior cruciate ligament. This sign also offers improved discrimination of complete from partial tears of the anterior cruciate ligament.


PMID: 8310927

DOI: 10.2214/ajr.162.2.8310927

Other references

Welsh, M.D., 1986: Acute radiation syndrome. Dimensions of Critical Care Nursing 5(5): 277-283

Pinel C.; Douce R.; Mache R., 1986: A study of mitochondrial ribosomes from the higher plant solanum tuberosum. Ribosomal subunits are isolated from potato tuber mitochondria devoid of containing organelles. The sedimentation constants of the two mitochondrial ribosomal subunits are 33S and 50S respectively. The apparent sizes of the high molecular weight R...

Benkov, B.; Benkov, B.V.S.ostakan; Tabanska, M., 1993: A research on the quality indexes of the sperm of Hampshire breed boars and the hybrid breed Hampshire x Belgian Landrace. The study was conducted at the pig breeding. complex of Guliantsi, district of Lovetch in 1989-1990 with 15 pure-blooded boars and 10 hybrid boars. 1959 ejaculation were obtained - 1238 from the pure-blooded and 721 from the hybrid boars respectiv...

Omodani, H.; Kinugawa, T.; Ogino, K.; Furuse, Y.; Yamaguchi, M.; Mori, M.; Endo, A.; Kato, M.; Kato, T.; Osaki, S.; Miyakoda, H.; Igawa, O.; Hisatome, I.; Shigemasa, C., 1999: Augmented exercise plasma noradrenaline with impaired chronotropic responsiveness in patients with hypertrophic cardiomyopathy. 1. There is controversy regarding plasma catecholamine levels in patients with hypertrophic cardiomyopathy (HCM) and few data exist on serial plasma catecholamine measurements during exercise. The present study determined whether cardiovascular an...

Haslam, D.R., 1984: The military performance of soldiers in sustained operations. Two 9-d tactical defensive exercises were carried out. The first assessed and compared the performance of three platoons of infantry scheduled for either 0, 1.5, or 3 h of sleep in every 24 h, and the second determined whether soldiers are likely...

Kelsey, Charles B.A.M., 1899: Surgery of the Rectum and Pelvis. Annals of Surgery 30: 133-136

Demidchik, V.V.; Sokolik, A.I.; Yurin, V.M., 2001: Intake of copper by plants and its distribution in plant cells, tissues, and organs. Literature concerning mechanisms of copper intake by plants are reviewed. Mechanisms of short and long distance transport of copper under deficient and adequate levels in the environment are discussed. Specialized transport by Cu2+ adenosinetripho...

Jang, J-Yong.; Chang, H-Jae.; Jang, Y.; Han, S-Hoon.; Bang, W-Dae.; Cho, S.Soo.; Oh, C-Myung.; Yu, H.Tae.; Shim, C.Young.; Ha, J.Won.; Chung, N., 2010: Constrictive Pericarditis Accompanied by Swine-Origin Influenza A (H1N1) Infection. Swine-origin influenza A (H1N1) is caused by a new strain of the influenza virus. The disease has spread rapidly and was declared a pandemic in April, 2009. So far, however, there is a scarcity of information regarding the complications of swine i...

Ribaut, H., 1923: L'urite IX des males chez les Pentatomides. Bull soc Hist nat Toulouse, 51: 183-184

Wainerdi Richard E., 1965: Nuclear explosives and their uses to the oil and gas industry. Producers Monthly 29(11): 22