Mcl Tear

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Mcl Tear

Authors, Editors, Case Information Author: Tyler Schmitz, DO Affiliation: Blue Ridge Orthopedics, Anderson SC Senior Editor: Wesley Troyer, DO Editor: Laura Mattson, DO Clinical Vignette: A 46-year-old female presents with a chief complaint of a medial-sided left knee injury that occurred 5 days prior in Muay Thai training when her opponent struck her knee on the lateral side causing a valgus force to the knee. Exam demonstrates mild swelling and tenderness to palpation at the medial femoral epicondyle and 1-2+ laxity with valgus stress test. Type of Probe Used: 15-6 MHz Linear Transducer #1 - Image Long axis view of the proximal MCL at medial femoral condyle. #2 - Image There is an anechoic defect in the inferior portion of the superficial fibers of the MCL at the femoral attachment that measures approximately 2.4 mm long x 2.3 mm thick x 3.1 mm wide. There is abnormal hypoechogenicity and thickening of the proximal MCL which measures approximately 6.5 mm. #3 - Image Short axis view of proximal MCL at medial femoral condyle. #4 - Image Hypoechoic defect visualized in short axis appreciating the anterior to posterior extent with surrounding edema. Interpretation Image Interpretation: Incomplete, Partial thickness, undersurface tear of the medial collateral ligament (MCL) at the femoral attachment, consistent with a grade 2 proximal MCL injury. Teaching Pearl: MCL injury is suggested when greater than 6 mm thick at the femoral attachment or greater than 3.6 mm thick at the tibial attachment. Because the MCL is a relatively flat structure, be sure to scan the full anterior to posterior extent. Reference: Lee JI, Song IS, Jung YB, Kim YG, Wang CH, Yu H, Kim YS, Kim KS, Pope TL Jr. Medial collateral ligament injuries of the knee: ultrasonographic findings. J Ultrasound Med. 1996 Sep;15(9):621-5. doi: 10.7863/jum.1996.15.9.621. PMID: 8866443.
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Authors, Editors, Case Information

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