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Year :2020
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Month :
January-February
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Volume :
9
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Issue :
1
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Page :
RO16 - RO19
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Evaluation of Anterolateral Ligament of Knee Using USG and MRI in Cases of Anterior Cruciate Ligament Tear
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Correspondence Address :
Sangram Panda, Jatavath Sravanthi, Gowri Shankar Kejriwal, Chamarthi Madhavi,
Dr. Jatavath Sravanthi,
B/730, Hill Colony, Nagarjunasagar, Nalgonda-508202, Telangana, India.
E-mail: dr.sravanthirad@gmail.com
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Introduction: Introduction: Injury patterns of recently debated and described Anterolateral Ligament (ALL) of the knee show internal rotation laxity with concomitant Anterior Cruciate Ligament (ACL) and Iliotibial Band (ITB) injuries. Evaluation of ALL by means of Ultrasonography (USG) and Magnetic Resonance Imaging (MRI) have become necessary for recognition and repair of the ALL lesions in cases of ACL tears to avoid high graft failure rates and residual postoperative rotational instability.
Aim: To compare the diagnostic ability of USG and MRI to detect ALL injuries in ACL tear patients.
Materials and Methods: A cross-sectional observational study was performed in a study population of 92 patients who were evaluated from August 2017 to June 2019. A 1.5-Tesla MRI and USG scan with the 12-MHz linear probe was used. Two radiologists evaluated the ALL individually on MRI and USG scans. The agreement between these examiner’s findings was evaluated with Cohen’s kappa.
Results: On MRI, ALL was identified in 97.8% of patients and appeared injured in 69.56% of cases (64/92, ?=0.83). Out of these 64 ALL injured patients, 4.34% of patients (4/92, ?=0.85) has segond fracture and the remaining 65.21% of patients (60/92, ?=0.89) ALL was found to be injured with intact enthesis. ALL was identified and visible over its entire length in 100% of patients in USG. The ALL was injured in 82.6% of cases (76/92, ?=0.91). An USG segond fracture was present in 34.78% of cases (32/92, ?=0.89) and enthesis was intact in 47.8% of cases (44/92, ?=0.93). There was a significant correlation between the USG and MRI findings for the ALL injury and segond’s fracture.
Conclusion: Although MRI can be used to identify and grade the extent of ALL injury, USG is seen to be more sensitive in the identification of normal anatomy and pathology. As most ALL injuries occur at the femoral or tibial portions, the USG may be useful as a diagnostic tool for ALL injury.
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