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Abstract
Among the MRI signs of meniscal bucket handle tears, a double posterior cruciate ligament (PCL) sign manifests on the sagittal images as a low signal band anterior and parallel to the PCL. The mesially displaced fragment may be confined to the intercondylar notch. However, the torn fragment is rarely displaced to the posterosuperior region of the PCL. If it does occur, separation at the anterior horn may be assumed. We propose this type of lesion be called the posterior double PCL sign in contrast to the ordinary double PCL sign. We present a case showing the 'posterior double PCL sign' accompanying an anterior cruciate ligament injury.
Figures and Tables
Fig. 1
MRI (A, B, C) of the knee shows no signal of the anterior cruciate ligament, a shortened peripherally nondisplaced portion of the medial meniscus (A, B), a fragment within the intercondylar notch sign (B) and a fragment in the backside of the posterior cruciate ligament (C, posterior double PCL sign). Arthroscopic findings (D, E, and F) show the complete absence of a medial meniscus on the medial compartment of the knee joint (D). A displaced fragment of the medial meniscus can be seen at the posteromedial corner (E) and the torn medial meniscus was removed (F).
Fig. 2
The hypothetic mechanism for the posterior double PCL sign. (A) Normal medial meniscus. (B) Ordinary bucket handle tear forming an anterior double PCL sign. (C) Torn anterior horn. (D) Released posterior flap tear. Mesially displaced fragment to the postero-superior side of the PCL resulting in a 'posterior double PCL sign'.
References
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