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Knee Injury & Cruciate Ligament Question & Answer

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0:01

Thanks again, Eric.

0:02

I mean, a lot of great cases

0:03

and you have that arthroscopic, uh, correlation,

0:06

which I think is, uh, terrific.

0:09

I was gonna ask you, uh, um, a question here.

0:12

You know, we know a lot about the deep notch

0:15

and people have measured it as, you know, greater than two

0:18

or suspicious one to two.

0:21

Um, do you have a measurement for a long notch?

0:24

Have you looked at that in terms of what is the normal

0:28

length, ap length of the lateral condyle, patella sulcus?

0:32

If not, it would be a good study to do. Okay.

0:35

And I don't know if you've done that, have you?

0:38

I haven't, no.

0:39

It, uh, uh, that would be a really good study

0:42

to do. Maybe we should do that.

0:43

Yeah. I, I think, and then the other thing,

0:46

and I don't want you to pull up your lecture again,

0:48

but when they have the double notch, you showed that, uh,

0:52

and, uh, I've seen it more often in the immature skeleton

0:55

where, and the injury is the second notch,

0:58

the posterior notch,

0:59

but when you look at it,

1:01

the anterior notch looks too far anteriorly.

1:04

So it's like a developmental lateral condyle,

1:08

patella sulcus, where it's not in the usual position.

1:12

It's a little bit more anteriorly.

1:14

I think it was on your case.

1:16

And it was on the cases Absolutely. That I showed as well.

1:18

So that's another thing that would be

1:21

a little bit interesting to, uh, to figure out.

1:24

But, uh, I just mentioned that there's one, uh, uh, question

1:28

that was, uh, submitted

1:29

and that is related to how I report partial tears,

1:32

to be honest, about partial tears

1:35

of the A CLI struggle with that.

1:38

Okay. I generally can indicate

1:40

that I see some collagen fibers, others look disrupted.

1:44

I try to gauge, um, how severe it is.

1:48

I often cannot tell what particular bundle is involved.

1:52

I don't think we're doing any OBL imaging specifically

1:56

of the anterior cruciate ligaments.

1:58

So I think it is very difficult.

2:00

But I would emphasize one of the points I made

2:03

with partial tears, and that is when they're examined

2:06

by the orthopedic surgeon, they can determine whether it,

2:09

how significant it is, whether

2:11

or not the knee is stable or not.

2:14

And that's probably the most important information rather

2:17

than the, uh, imaging information.

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