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Thursday, October 29, 2009

Lateral Collateral Ligament Tear

Cor T1

Cor T2 Fat Sat



Ax PD Fat Sat

Lateral collateral ligament (LCL) tear
The lateral collateral ligament (LCL) arises from the lateral femoral condyle and inserts on the lateral aspect of the middle third of the fibular head, sometimes joining the biceps femoris tendon. This ligament has a posterior and oblique course and is seldom seen entirely on one coronal image. The LCL is 5-7 cm long, extracapsular, and free from meniscal attachments.The location of the injury relative to the lateral collateral ligament can be proximal, mid substance, or at the fibular insertion. MRI appearance of an LCL tear depends less on the degree of tearing. Most commonly an acute LCL tear is seen as a serpiginous or lax ligament with discontinuous fibers (or avulsed fibular head), often without significant thickening of the ligament.
Cor T1
Cor T2 Fat Sat
Ax PD Fat Sat
Lateral collateral ligament is a part of lateral supporting structures of the knee commonly and collectively referred to as the posterolateral corner (PLC) or posterior lateral arcuate complex. The PLC includes the LCL, popliteus tendon, lateral head of the gastrocnemius, arcuate ligament and, occasionally, popliteofibular and fabellofibular ligaments. Similar to MCL tears, isolated injuries of the LCL are uncommon and typically occur in association with ACL or posterior cruciate ligament (PCL) tears.The lateral collateral ligament (LCL) arises from the lateral femoral condyle and inserts on the lateral aspect of the middle third of the fibular head, sometimes joining the biceps femoris tendon. This ligament has a posterior and oblique course and is seldom seen entirely on one coronal image. The LCL is 5-7 cm long, extracapsular, and free from meniscal attachments.The grading system for classifying both MCL and LCL tears is the same as that used for other ligaments evaluated by MRI as follows: Grade 1 - Microscopic tears Grade 2 - Partial tears Grade 3 - Complete tearsThe location of the injury relative to the lateral collateral ligament can be proximal, mid substance, or at the fibular insertion. MRI appearance of an LCL tear depends less on the degree of tearing. Most commonly an acute LCL tear is seen as a serpiginous or lax ligament with discontinuous fibers (or avulsed fibular head), often without significant thickening of the ligament. As mentioned above, LCL tears rarely are isolated, and an LCL tear becomes more likely as associated PLC and cruciate ligament injuries increase in severity. A chronic LCL tear appears as a thickened low T1/T2-weighted signal ligament.Suggested Reading:Miller TT, Gladden P, Staron RB, Henry JH, Feldman F. Posterolateral stabilizers of the knee: anatomy and injuries assessed with MR imaging. AJR 1997;169:1641 -1647. 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.




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