Bone Bruise Sign
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Atlas of Signs in Musculoskeletal Radiology is approved by the ARRS (American Roentgen Ray Society) and is included in AJR Webreview
A. Gentili,MD, M. Beller, MD, S. Masih, MD, L.L. Seeger, MD

Diagnosis:

ACL Tear

Discussion:

Sagittal T2 weighted and proton density images which reveal complete tear of the ACL with mild increase in marrow signal in the adjacent osseous structures. The bone bruises, as evidenced by increased signal within the marrow, is likely caused by anterior subluxation of the tibia at the time of tear of the ACL accompanied by impaction of the middle portion of the lateral femoral condyle against the posterior portion of the lateral tibial plateau. Signal intensity abnormalities are probably secondary to edema, hemorrhage, and microfracture.


T2W - Click on the image for a larger versionAProton Density - Click on the image for a larger versionB

References:

bulletGentili A, Seeger LL, Yao L, Do HM: Anterior cruciate ligament tear: indirect signs at MR imaging. Radiology 1994 Dec;193(3):835-40.          [See related articles]
bulletGraf BK, Cook DA, De Smet AA, Keene JS: Bone bruises on magnetic resonance imaging evaluation of anterior cruciate ligament injuries. Am J Sports Med 1993 Mar-Apr;21(2):220-3.          [See related articles]
bulletMurphy BJ, Smith RL, Uribe JW, Janecki CJ, Hechtman KS, Mangasarian RA: Bone signal abnormalities in the posterolateral tibia and lateral femoral condyle in complete tears of the anterior cruciate ligament: a specific sign? Radiology 1992 Jan;182(1):221-4.          [See related articles]

 

 

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Atlas of Signs in Musculoskeletal Radiology is approved by the ARRS (American Roentgen Ray Society) and is included in AJR Webreview
A. Gentili,MD, M. Beller, MD, S. Masih, MD, L.L. Seeger, MD