HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Juhng, S.-K. Articles by Won, J.-J. Search for Related Content PubMed PubMed Citation Articles by Juhng, S.-K. Articles by Won, J.-J. Social Bookmarking                      What's this?

MR Evaluation of the "Arcuate" Sign of Posterolateral Knee Instability

¹ Department of Diagnostic Radiology, Wonkwang University School of Medicine and Institute of Wonkwang Medical Science, 344-2 Shinyong-dong, Iksan, Jeonbuk, 570-711, South Korea.
² Image Care of Troy, 451 Hoosick St., Troy, NY 12180.

OBJECTIVE. The purpose of this study was to evaluate associated knee injuries using MR imaging in patients with the "arcuate" sign, a term referring to avulsion fracture of the proximal fibula on conventional radiographs.

MATERIAL AND METHODS. MR imaging of 18 cases (17 patients, both knees in one patient) with the arcuate sign on conventional radiographs was retrospectively interpreted to evaluate the associated meniscal, ligamentous, and bony injuries. In 12 cases, MR findings were correlated with surgical results.

RESULTS. In all cases, avulsed bony fragments from the proximal pole of the fibula were attached to the fibular collateral ligament, the biceps femoris tendon, or both. Tear of the posterolateral capsule was seen in 12 cases (67%). Injury of the cruciate ligaments was noted in 16 cases (89%): injury to both the anterior cruciate ligament and posterior cruciate ligament was seen in nine cases (50%), injury to only the anterior cruciate ligament was seen in four, and injury to the posterior cruciate ligament only was noted in three. Bone bruises or gross fractures were seen in all cases: bone bruises on the anteromedial femoral condyle were noted in nine cases (50%) and were seen on the anteromedial tibial condyle in five cases (28%). Tear of the medial meniscus was seen in five cases (28%) and tear of the lateral meniscus in four cases (22%). Injury to the popliteus was seen in six cases (33%). Joint effusion was associated in all cases.

CONCLUSION. MR imaging is useful for evaluation of associated soft-tissue injuries in patients with the arcuate sign on conventional radiographs. Avulsion injury to the proximal fibula is an important indicator of the internal derangement of the knee and for predicting the mechanism of an injury with varus stress. Cruciate ligament tear and bone bruises on the anteromedial condyle of the femur and tibia are common associated findings.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				E. N. Vinson, N. M. Major, and C. A. Helms The Posterolateral Corner of the Knee Am. J. Roentgenol., February 1, 2008; 190(2): 449 - 458. [Abstract] [Full Text] [PDF]

				W. M. Strub The Arcuate Sign Radiology, August 1, 2007; 244(2): 620 - 621. [Full Text] [PDF]

				A. H. Haims, M. J. Medvecky, R. Pavlovich Jr., and L. D. Katz MR Imaging of the Anatomy of and Injuries to the Lateral and Posterolateral Aspects of the Knee Am. J. Roentgenol., March 1, 2003; 180(3): 647 - 653. [Full Text] [PDF]

				G.-S. Huang, J. S. Yu, M. Munshi, W. P. Chan, C.-H. Lee, C.-Y. Chen, and D. Resnick Avulsion Fracture of the Head of the Fibula (the "Arcuate" Sign): MR Imaging Findings Predictive of Injuries to the Posterolateral Ligaments and Posterior Cruciate Ligament Am. J. Roentgenol., February 1, 2003; 180(2): 381 - 387. [Abstract] [Full Text] [PDF]