2022 Dec;30(12):1647-1657. doi: 10.1016/j.joca.2022.08.006. 1 Kacey Court, Suite 100, Mechanicsburg, Pa, 17055. MR feature of bone bruising reflects increase in water content in marrow cavity as a result of haemorrhage, therefore water sensitive sequence like fat saturated T2W, PD weighted image or STIR are used [1,11,12]. Boks SS, Vroegindeweij D, Koes BW, Hunink MG, Bierma-Zeinstra SM. 2014 Feb;44(2):281-93. doi: 10.1007/s40279-013-0116-z. Archives of Orthopaedic and Trauma Surgery Radiology. Anterior tibial plateau oedema and rupture of the posterior capsule predicted cruciate ligament injury [OR=10.5 (p=0.02) and 24.0 (p=0.001) respectively]. government site. 5 Resident, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. Compression and tension are two basic loads that commonly act on the knee [4]. NAME, ADDRESS, E-MAIL ID OF THE CORRESPONDING AUTHOR: Dr. Ashish Garg, A-4, Ashok Nagar, Mandoli Road, Shahdara, Delhi-110093, India. To identify imaging pattern in bone marrow oedema and to correlate the pattern of bone marrow oedema retrospectively with type of knee injury from clinical history. MRIs, plain radiographs and clinical details of these patients were reviewed. Kissing contusion is a significant injury often associated with ligamentous or menisceal injuries. Other structures are injured less frequently and have weaker associations with bone bruise distribution. None of the knees had been injured before. 10 0 obj Conclusions: J Orthop Surg Res. Study of imaging pattern in bone marrow oedema in MRI in recent knee injuries and its correlation with type of knee injury. Bone bruising of the knee. 2021 Nov 11;6(4):e21.00069. The authors declare that they have no conflict of interest. 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]. The site is secure. Google Scholar. This is a preview of subscription content, access via your institution. "Kissing contusion" refers to a bone contusion on both side of the knee joint. Presence of contusion may also effect management of knee injuries often requiring prolonged rest even in absence of surgical correctible lesion and establishing diagnosis of bone marrow contusion may obviate further costly work up like arthroscopy. Knee Surg Sports Traumatol Arthrosc. Bone marrow contusion is transient dislocation of patella noted in anterior aspect of lateral femoral condyle and inferiomedial aspect of patella in all the cases (100 %). Boks SS, Vroegindeweij D, Koes BW, Bernsen RM, Hunink MG, Bierma-Zeinstra SM. 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. "The appearance of kissing contusion in the acutely injured knee in the athletes", https://en.wikipedia.org/w/index.php?title=Kissing_contusion&oldid=903873252, Creative Commons Attribution-ShareAlike License 3.0, This page was last edited on 28 June 2019, at 13:40. 1996 Sep;(330):133-42 In this study hyperextension injury noted in 4 cases in 138 cases (2.9%). Inclusion criteria were patients with recent knee injuries (<6weeks) and normal plain radiograph with no signs of pathology. Epub 2022 Apr 12. Am J Sports Med. Oedema or interisital fluid within marrow extracellular space similar to free fluid shows long T1 and T2 decay characteristics and appear hypointense on T1 and hyperintense on T2W. There were high rates of injury to the posterior capsule (52%), ACL (40%) and PCL (40%) but lower rates of injury to the menisci (20%), medial and lateral collateral ligaments (16%) and posterolateral corner (16%). Check for errors and try again. 2000;28:6637. 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); medial tibial condyle (n = 7; 2 type I, 5 type III); medial femoral condyle (n = 2; both type I). Ali, A.M., Pillai, J.K., Gulati, V. et al. 99 0 obj This mechanism of injury involves other soft tissue structures like tears/posterior capsule and arcuate ligament, medial collateral ligament (MCL) and the menisci. Am J Sports Med 42(1):235241, Garth WP Jr, Greco J, House MA (2000) The lateral notch sign associated with acute anterior cruciate ligament disruption. 2. Other structures are injured less frequently and have weaker associations with bone bruise distribution. Google Scholar. In distraction injury, excessive tension may damage the joint capsule, retinacula, ligaments, and tendons as well as their osseous attachment sites. Disclaimer. Call Us Today! CAS Wright RW, Phaneuf MA, Limbird TJ, Spindler KP. According to study conducted by Terzidis et al., Kissing contusion in acute knee injury is noted in 16 cases out of 225 (7.1%). Most common type / mode of injury in patients with unclassified pattern in fall from bike (3 cases) followed by hit by car/ motor vehicle (2 cases) and injury while lifting heavy weight in 1 case [Table/Fig-13]. A 14-year-old male football player with chronic anterior knee pain who experienced acute knee pain after jumping and landing awkwardly. E-mail: Received 2016 Jan 13; Revisions requested 2016 Jan 29; Accepted 2016 Feb 28. J Clin Diagn Res. Hyperextension results in the "kissing" contusion pattern involving the anterior aspect of the proximal tibia and distal femur. 1020 AJR:196, May 2011 Pai and Strouse ulation [2, 3]. This case demonstrates a hyperextension knee injury consisting of partial posterior cruciate ligament tear proximal tibia epiphysis bone contusion and minor "kissing contusion" of the lateral femoral condyle posterior soft tissue injuries involving the knee joint capsule, fibular attachment of soleus and distal semimembranosus tendon Magnetic resonance imaging of bone bruising in the acutely injured kneeshort-term outcome. Follow-up of occult bone lesions detected at MR imaging: systematic review. Anterior tibial plateau oedema and rupture of the posterior capsule predicted cruciate ligament injury [OR = 10.5 (p = 0.02) and 24.0 (p = 0.001) respectively]. Bone marrow contusion at posterior lip of medial tibial condyle was seen in 59 cases. A 124(62%) had trauma in right knee and 76(38%) in left knee. Our results therefore suggest that kissing contusions are more common following knee hyperextension than in other forms of knee injury and predominantly affect the medial side. In addition to trauma, marrow oedema can be seen in a broad spectrum of entities, including infection, transient osteoporosis of the hip bone marrow, and neoplasm demonstrates relatively hyperintense T2 and hypointense T1 signal, but the clinical history and location of injury typically allows the correct diagnosis to be made [2]. Clin Radiol 2004;59:439-445. MRI is used widespread to interpret more complex injuries. Radiographics. -, Am J Sports Med. This was comparable to study conducted by Kirsch et al., in who reported transient lateral patellar dislocation in 2% cases with acute knee injuries and bone marrow contusion is noted in lateral femoral condyle in 81% and contusion in patella in 19% cases [15]. On analysing the bone marrow contusion pattern, type/mode can be determined in most of cases. 3 Professor, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. 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. Over the lifetime, 3 publication(s) have been published within this topic receiving 31 citation(s). 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]. from publication: The appearance of kissing contusion in the acutely injured knee in the athletes | Bone contusions are often identified at magnetic resonance imaging (MRI) in the acutely. All the patients underwent magnetic resonance imaging (MRI) preoperatively, and the diagnosis was confirmed with the aid of arthroscopy. Reference article, Radiopaedia.org (Accessed on 02 May 2023) https://doi.org/10.53347/rID-43268, Case 3: pivot-shift injury with ACL and meniscal tears, Case 4: pivot-shift injury with impacted tibial plateau fracture, see full revision history and disclosures, doi:10.1148/radiographics.20.suppl_1.g00oc19s135, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, Ahlback classification system in assessing osteoarthritis of the knee joint, Kellgren and Lawrence system for classification of osteoarthritis, anterior cruciate ligament mucoid degeneration, MRI grading system for meniscal signal intensity, Pattern of bone contusion in knee injuries, valgus stress to flexed and externally rotated knee, contusion pattern:posterolateral tibial plateau and mid part of lateral femoral condyle, anterior force to tibia in a flexed knee (e.g. 2016;10(4):TC0611. The double sulcus sign is a radiographic marker that confers a high probability of ACL injury. PDFS Saggital: Bone marrow oedema at proximal tibia in Dashboard injury. This pattern is thought to result resolution from contrecoup forces in the medial compartment at the forced valgus forces. {"url":"/signup-modal-props.json?lang=us"}, Knipe H, Yap J, Al Kabbani A, et al. Acta Radiol. Bone contusions were diagnosed in 71 cases (27.8%); 55 (22.5%) were identified as single contusions and 16 (6.3%) as kissing contusions. Expansive network access, savings and no red tape An absolute win-win foreveryone! Kaplan PA, Gehl RH, Dussault RG, Anderson MW, Diduch DR. 2023-05-01T23:01:26-07:00 Bone marrow oedema is responsible for patient symptoms and may lead to early degenerative changes [7]. 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. Epub 2022 Mar 1. T1W Saggital: Bone marrow oedema at Lateral femoral condyle in Clip injury pattern. In present study transient dislocation of patella pattern is noted in 3 cases (2.2%). Bone contusion of knee: Increase lesion detection with fast spin echo MR Imaging with spectroscopic Fat saturation. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. bone contusion) can give clues for the mechanism and associated injuries. Exclusion criteria were history of any infection, surgery or neoplasm of knee joint, patients having any prosthetic heart valve implant, any pacemaker implant, aortic stent graft, cochlear implant or any metallic orthopedic implants, any joint replacement surgery and claustrophobic patients. Sanders classified bone marrow contusions in five different patterns as: Clip injury, Pivot shift injury, Dashboard injury, Hyperextension injury, and Lateral patellar dislocation [8]. 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. Analysis of bone marrow oedema was done by a single observer based on MRI [9], its patterns were studied and possible type/mode of injury was determined before elucidating the history from the patient. HHS Vulnerability Disclosure, Help FOIA 1989 Sep;27(5):983-1002 Type/Mode of injury were twisting injury while getting downstairs (1 case), twisting injury while doing household work (1 case) and injury while playing football (1 case). T2 Axial: Bone marrow oedema in Inferiomedial aspect of patella and lateral femoral condyle in lateral patellar dislocation. The site is secure. Am J Sports Med 28(1):6873, Gentili A, Seeger L, Yao L, Do H (1994) Anterior cruciate ligament tear: indirect signs at MR imaging. - 134.209.62.117. +(91)-9821210096 | paula deen meatloaf with brown gravy. 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. 2000;20 Spec No (suppl_1): S135-51. The primary aim of the study was to identify imaging pattern in bone marrow oedema and to correlate the pattern of bone marrow oedema retrospectively with type of knee injury from clinical history. PubMed Mandalia V, Fogg AJB, Chari R, Murray J, Beale A, Henson JHL. 31 0 obj CAS Clipboard, Search History, and several other advanced features are temporarily unavailable. -, Acta Orthop Scand. A prospective study of the association between bone contusion and intra-articular injuries associated with acute anterior cruciate ligament tear. -, Radiology. In our study, bone marrow oedema was seen in 138 cases (69%) out of 200 cases. In these 16 cases, contusion in medial compartment was noted in 2 cases (12.5%) [13]. Bone contusion and associated meniscal and medial collateral ligament injury in patients with anterior cruciate ligament rupture. National Library of Medicine 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. Google Scholar, Bernard M, Pappas E, Georgoulis A, Haschemi A, Scheffler S, Becker R (2020) Risk of overconstraining femorotibial rotation after anatomical ACL reconstruction using bone patella tendon bone autograft. 2013 Aug;41(8):1801-7. doi: 10.1177/0363546513490649. A knee contusion can usually be treated . endobj Correspondence to Home; Service. By analysing bone marrow contusion pattern, type/mode can be determined in most of the cases. 1999 Jun;211(3):747-53 2004;38:5926. uuid:a4a67e1a-1dd1-11b2-0a00-880000000000 Shi H, Ding L, Jiang Y, Zhang H, Ren S, Hu X, Liu Z, Huang H, Ao Y. Orthop J Sports Med. Results: Bone contusion patterns of the knee at MR imaging: footprint of the mechanism of injury. The usefulness of the oblique coronal plane in knee MRI on the evaluation of the posterior cruciate ligament. 5 out of 8 patients with a double sulcus on the lateral radiograph had ACL injury. Accessibility Bone bruise in the acutely injured knee. Google Scholar; . Kapelov et al., conducted a study to demonstrate that T2 weighted fast spin echo (FSE) images with spectroscopic fat saturation (FS- FSE) increase conspicuity between marrow contusion and normal marrow in post traumatic knee and found bone marrow contusion in 21 out of 76 cases (27.6%) which is less than our study (69%) [11]. 2023 Feb;143(2):927-934. doi: 10.1007/s00402-022-04366-9. Diagnostic value of the lateral femoral notch sign and kissing contusion in patients with anterior cruciate ligament injuries: a case-control study. KIS Imaging is the nations largest direct contracting imaging network with over 2,600 providers covering all major imaging needs: MRI, CT and PET. Emerg Radiol 2:129134, Article Objective: To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint.
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