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Acute Anterior Cruciate Ligament Stump Entrapment in Anterior Cruciate Ligament Tears: MR Imaging Appearance¹

¹ From the Departments of Radiology (G.S.H., C.Y.C.), Orthopedic Surgery (C.H.L.), and Pathology (H.S.L.), Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Rd, Neihu, Taipei 114, Taiwan, R.O.C.; Department of Radiology, Taipei Medical University-Municipal Wan Fang Hospital, Taipei, Taiwan, R.O.C. (W.P.C.); and Department of Radiology, Ohio State University Medical Center, Columbus (J.S.Y.). Received November 9, 2001; revision requested December 12; revision received March 1, 2002; accepted April 3. Address correspondence to G.S.H. (e-mail: gsh5@seed.net.tw).

View larger version (182K): [in a new window]   Figure 1a. Entrapped type 1 ACL stump in a 24-year-old man with diminished knee extension after an acute ACL tear. The MR examination was performed 6 weeks after knee injury. (a) Sagittal spin-echo intermediate-weighted MR image (1,800/20) shows a nodular mass representing the free end of the entrapped ACL stump (arrow) between the anterior aspect of the lateral femoral condyle and tibia. (b) Coronal spin-echo T2-weighted MR image (1,800/90) shows regions of high signal intensity (arrow) indicative of inflammation. (c) Arthroscopic image reveals a white and reddish mass representing the free end of the ACL stump (arrowhead) protruding out of the intercondylar notch and impinged by the lateral femoral condyle (*).

View larger version (179K): [in a new window]   Figure 1b. Entrapped type 1 ACL stump in a 24-year-old man with diminished knee extension after an acute ACL tear. The MR examination was performed 6 weeks after knee injury. (a) Sagittal spin-echo intermediate-weighted MR image (1,800/20) shows a nodular mass representing the free end of the entrapped ACL stump (arrow) between the anterior aspect of the lateral femoral condyle and tibia. (b) Coronal spin-echo T2-weighted MR image (1,800/90) shows regions of high signal intensity (arrow) indicative of inflammation. (c) Arthroscopic image reveals a white and reddish mass representing the free end of the ACL stump (arrowhead) protruding out of the intercondylar notch and impinged by the lateral femoral condyle (*).

View larger version (110K): [in a new window]   Figure 1c. Entrapped type 1 ACL stump in a 24-year-old man with diminished knee extension after an acute ACL tear. The MR examination was performed 6 weeks after knee injury. (a) Sagittal spin-echo intermediate-weighted MR image (1,800/20) shows a nodular mass representing the free end of the entrapped ACL stump (arrow) between the anterior aspect of the lateral femoral condyle and tibia. (b) Coronal spin-echo T2-weighted MR image (1,800/90) shows regions of high signal intensity (arrow) indicative of inflammation. (c) Arthroscopic image reveals a white and reddish mass representing the free end of the ACL stump (arrowhead) protruding out of the intercondylar notch and impinged by the lateral femoral condyle (*).

View larger version (158K): [in a new window]   Figure 2a. Entrapped type 2 ACL stump in a 21-year-old man with restricted knee extension after an acute ACL rupture. The MR examination was performed 7 days after the injury. (a) Sagittal spin-echo T2-weighted MR image (2,100/90) shows a tonguelike (arrow) free end of the ruptured ACL stump and angulation, causing the stump to be displaced out of the intercondylar notch into the anterior joint recess. (b) Coronal spin-echo T2-weighted MR image (2,100/90) shows the entrapment of the ACL stump (arrow).

View larger version (154K): [in a new window]   Figure 2b. Entrapped type 2 ACL stump in a 21-year-old man with restricted knee extension after an acute ACL rupture. The MR examination was performed 7 days after the injury. (a) Sagittal spin-echo T2-weighted MR image (2,100/90) shows a tonguelike (arrow) free end of the ruptured ACL stump and angulation, causing the stump to be displaced out of the intercondylar notch into the anterior joint recess. (b) Coronal spin-echo T2-weighted MR image (2,100/90) shows the entrapment of the ACL stump (arrow).