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Normal and Acutely Torn Posterior Cruciate Ligament of the Knee at US Evaluation: Preliminary Experience¹

¹ From the Departments of Diagnostic Radiology (K.H.C., B.H.P.) and Orthopedic Surgery (D.C.L., S.D.K.), Yeungnam University Medical Center, College of Medicine, 317-1 Daemyung-Dong, Nam-Ku, Taegu 705-717, Korea; the Department of Diagnostic Radiology, National University Hospital, Faculty of Medicine, National University of Singapore (R.K.C.); the Department of Diagnostic Radiology, Henry Ford Hospital, Detroit, Mich (J.A.B.); and the Department of Diagnostic Radiology, St-Luc Hospital, Montreal, Quebec, Canada (E.C.). Received August 6, 1998; revision requested September 11; final revision received September 26, 2000; accepted October 11. K.H.C. supported in part by the Chunma Foundation for Medical Science. Address correspondence to K.H.C. (e-mail: khcho@medical.yeungnam.ac.kr).

PURPOSE: To determine the ultrasonographic (US) findings of normal and acutely torn posterior cruciate ligament (PCL) of the knee and evaluate the usefulness of US in the injured PCL.

MATERIALS AND METHODS: US images were obtained in 30 knees in 15 asymptomatic volunteers as a control group and in 35 patients clinically suspected of having an acute PCL injury. Only the distal half of the PCL was evaluated. Of the 35 patients, 28 had their PCL status confirmed: 13 had a normal PCL at magnetic resonance (MR) imaging plus clinical examination, and 15 had a torn PCL at either MR imaging and surgery or MR imaging and clinical follow-up.

RESULTS: Normal PCLs were homogeneously hypoechoic, with a well-defined posterior border. Torn PCLs were heterogeneously hypoechoic (12 [80%] of 15 patients), with an indistinct posterior margin (11 [73%] of 15 patients). Torn PCLs were significantly thicker (range, 12.0–20.0 mm; mean, 15.6 mm ± 2.5 [SD]; P < .01), as compared with normal PCLs in 13 patients (range, 3.8–5.8 mm; mean, 4.6 mm ± 1.0; P < .01) and in the volunteers (range, 3.7–6.2 mm; mean, 4.5 mm ± 1.2; P < .01).

CONCLUSION: An acutely torn PCL thickens (>10 mm), loses its sharply defined posterior border, and has a heterogeneously hypoechoic appearance. US may be useful as a screening examination for patients suspected of having PCL injury and for deciding whether to perform more expensive MR imaging or surgical intervention.

Index terms: Knee, injuries, 4526.1298, 4526.4857 • Knee, ligaments, menisci, and cartilage, 4526.1298, 4526.4857 • Knee, US, 4526.1298, 4526.4857

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