Very interesting....I often wonder how to "date" some injuries. I don't understand what you mean by the ACL, PCL were intact in CR 1 month prior---how do we know that? I actually think we can see the contour of the avulsion as a lucency in the AP XR---if the CR was prior to injury, it would mean its chronic. That said---avulsions often incite very little BME. The fact that there is bright signal in the defect isn't helpful----because, though it might be acute/subacute...it can also be chronic but unstable.
Bjorn....I'm not sure how I managed it, but I threw arrows onto your XRs...I'm sure i see the avulsion fx in the AP---might be hallucinating in the lateral. When were the radiographs obtained with respect to her date of injury?
Very interesting....I often wonder how to "date" some injuries. I don't understand what you mean by the ACL, PCL were intact in CR 1 month prior---how do we know that? I actually think we can see the contour of the avulsion as a lucency in the AP XR---if the CR was prior to injury, it would mean its chronic. That said---avulsions often incite very little BME. The fact that there is bright signal in the defect isn't helpful----because, though it might be acute/subacute...it can also be chronic but unstable.
ReplyDeleteSince the full contour of the ACL and PCL is not shown, I meant to say that, aside of the avulsion, the fibre bundles are intact on MR.
ReplyDeleteBjorn....I'm not sure how I managed it, but I threw arrows onto your XRs...I'm sure i see the avulsion fx in the AP---might be hallucinating in the lateral. When were the radiographs obtained with respect to her date of injury?
ReplyDelete