Pathology:Meniscal bucket handle tear, with inner
meniscal fragment displaced into the intercondylar notch,
anterior and lateral to the ACL.Double ACL
sign commonly occurs with lateral meniscal bucket handle tears.
findings:Band of low signal
intensity, anterior and lateral to the ACL (sagittal view).Because of the oblique orientation of the
ACL, the meniscal fragment may parallel and simulate the ACL when
viewed on oblique sagittal orientation.Band of low signal intensity may be seen within
the intercondylar notch, parallel to the ACL; associated truncation of
triangular configuration of peripheral meniscus (coronal view).
Note: The double
ACL sign tear may be considered as a subset of fragment-in-notch
type meniscal tears, in which the displaced fragment lies in the
same sagittal plane as the PCL.