PCL Anatomy & Pathology
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I'm gonna cover quickly the posterior cruciate ligament.
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Okay, we're gonna do this rather quickly
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because it's injured much less frequently than the anterior
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cruciate, although again,
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there's some controversy about the com, the composition
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of the posterior cruciate.
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Most people use bundles
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and describe two bundles rather than
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multiple collagen regions to, for the posterior uh,
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cruciate ligament, there's an anterolateral bundle
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representing the bulk of the ligament, the stronger part,
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and there's a postal medial bundle.
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They're labeled here in the diagram,
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representing a smaller part of the ligament book nearby.
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There are the posterior posterolateral meniscal femoral
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ligaments of berg and Humphrey,
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and together these are often called the PCL complex.
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I wanted to show you what the ligament
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of berg look like in a coronal uh, imaging and a cadaver.
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You can see it here crossing from the posterior horn
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of the lateral meniscus behind the PCL.
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And here I'm showing you the ligament
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of Humphrey on transverse images proximal
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to distal the black arrows tracing the course of
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that ligament in front of the posterior cruciate ligament.
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There are variations, particularly in the ligament of berg.
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It may in fact be bifurcated without being torn.
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I show you an example in the top images on your right
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and in some cases the berg ligament ends in the mid portion
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of the posterior cruciate ligament leading to focal
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thick appearance of that portion
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of the posterior cruciate ligament.
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The images at your top are showing you
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the humphrey ligament located just in front of
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a normal posterior cruciate ligament.
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So in the sagal images,
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typically the posterior cruciate ligament is of low signal
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and has a gentle curve as shown.
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In this particular case.
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Here is a my diagram showing you
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what a posterior cruciate ligament looks like
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with a ligament of Humphrey and a ligament of berg.
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And I want to comment that in these cases,
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sometimes it becomes a little bit difficult to sort out
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what might be these meniscal femoral ligaments
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and what might be the posterior cruciate ligament.
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In this particular example, we can see here
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probably a ligament of Humphrey.
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Here's the ligament of berg.
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Now, when we have a joint effusion without a torn posterior
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cruciate ligament, you may see fluid posterior
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to the posterior cruciate.
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When we have tearing of the posterior cruciate ligament,
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often the posterior capsule is torn
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and you'll see fluid leakage behind the femur,
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behind the tibia, or behind the the joint, as in this case.
Donald Resnick, MD
Professor Emeritus, Department of Radiology
University of California, San Diego
Mini N. Pathria, MD, FRCP(C)
Division Chief, Musculoskeletal Imaging
University of California San Diego
Eric Y. Chang, MD
Adjunct Professor, Radiology
University of California, San Diego
Brady K. Huang, MD
Clinical Professor of Radiology
UC San Diego Medical Center
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