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Pure Distraction Injury

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Now, I left one particular mechanism behind

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because it is unusual,

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but it happened to a friend of mine many, many years ago.

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So I'd like to show his particular images.

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This is a pure distraction injury.

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So the story here is a 42-year-old male rheumatologist

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who took up skiing at the age of 42 years.

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He was a very conservative person.

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He had all of the safety precautions in place

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on the first day, true story, first run down the mountain.

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Worse than that, the first hundred feet,

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he ran into some trouble.

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So what happened? Well, according to the observers,

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it was a beautiful day.

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He was at the top of the mountain.

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He didn't understand what expert meant.

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All right, so he found himself on an expert trail.

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He traveled down less than a hundred feet.

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He hit a snow bank there and did something like this.

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Now, when you talk to him, he said,

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that's not exactly what happened.

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It was a terrible day. It was snowing.

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He did something more like this, all right,

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and ended up in the snow.

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But whatever the true history, he said that

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as he was spinning,

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he felt like his knee was being pulled apart.

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Distracted, and he heard some strange noise

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coming from his knee.

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So here are the images.

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They're from years ago, but they show you what he had.

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He had a complete tear involving the anterior cruciate

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ligament and a high grade tear

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of the medial collateral ligament.

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But what he did not have, in fact, was any evidence

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of footprints left behind.

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So no evidence of either an external blow, it was soft snow,

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or an internal blow where the femur and tibia collided.

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That's what you see when there is a distraction injury.

Report

Faculty

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

Tags

Musculoskeletal (MSK)

MRI

Knee