33 0 obj Hyperextension results in the "kissing" contusion pattern involving the anterior aspect of the proximal tibia and distal femur. In tensile load, on the other hand, bones pull apart leading to distraction across the joint and traction on stabilizing structures. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Provided by the Springer Nature SharedIt content-sharing initiative, Over 10 million scientific documents at your fingertips, Not logged in PDFS Coronal: Bone marrow oedema at Medial femoral condyle and Metadiaphysis. Careers. Anterior tibial plateau oedema and rupture of the posterior capsule predicted cruciate ligament injury [OR = 10.5 (p = 0.02) and 24.0 (p = 0.001) respectively]. (2008) ISBN:0323076211. 2 Resident, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. Contusions of both surfaces of the knee joint are known as kissing contusions. We describe the clinical and radiographic features of 11 athletes found to have femoral head lesions similar in MR imaging appearance to osteochondral lesions in other locations, such as the knee and ankle. Ali, A.M., Pillai, J.K., Gulati, V. et al. In compressive load, bones collide leading to impaction. Imaging the knee: Ligaments. [Table/Fig-10,,1111 and and12]12] show the aetiologies and location for pivot shift injury, Type /Mode of injury among dashboard injury pattern (8 cases) were - Impact from dashboard in 4 cases, fall from bike (2 cases), running downstairs (1 case) and fall while paying cricket (1 case). 1. Radiology. The lateral femoral notch sign following ACL injury: frequency, morphology and relation to meniscal injury and sports activity. MRI Introduction Anterior cruciate ligament (ACL) injuries are among the most common sports injuries. Transient lateral patellar dislocation: review of imaging findings Bone Marrow Edema Injury Patterns in the Pediatric Knee: An MRI Study. 2000;20:S13551. Pure passive hyperextension of the human cadaver knee generates simultaneous bicruciate ligament rupture. A prospective study of the association between bone contusion and intra-articular injuries associated with acute anterior cruciate ligament tear. Please enable it to take advantage of the complete set of features! Kirialanis P, Malliou P, Beneka A, Giannakopoulos K. Occurrence of acute lower limb injuries in artistic gymnasts in relation to event and exercise phase. PubMed Central https://doi.org/10.1007/s00256-017-2754-y, DOI: https://doi.org/10.1007/s00256-017-2754-y. HHS Vulnerability Disclosure, Help The oedema pattern & suspected type/mode of injury on basis of MRI were then correlated with detailed patients history on mode of injury. 2016;10(4):TC0611. CAS Acute findings of a joint effusion and posterior tibial plateau contusion are present. Meniscal injury was unrelated to the extent or pattern of bone bruising. 2011;93:15108. "Kissing contusions," a commonly seen secondary sign of ACL injury caused by the previously mentioned pivot-shift mechanism of injury, occur on the posterior aspect of the tibial plateau and the mid to anterior aspect of the femoral condyle (Figure 4). Wright RW, Phaneuf MA, Limbird TJ, Spindler KP. CAS Study was conducted between May 2014 to September 2015 with a sample size of 200 patients. . Terzidis IP, Christodoulou AG, Ploumis AL, Metsovitis SR, Koimtzis M, Givissis P. The appearance of kissing contusion in the acutely injured knee in the athletes. endobj Imaging Services | HCA Valley Regional Medical Center | Valley Regional On 1.5 T, knee joint was examined in Saggital (T1, T2, PD, PDFS), Coronal (T2/ PDFS), Axial (T2, Medic) sequences. No cost for the Employer or Employee with up to 80% savings. It is a common injury that can occur from a fall, blow, or collision. Popular works include The appearance of kissing contusion in the acutely injured knee in the athletes, Role of Magnetic Resonance Imaging in Study of the Patellofemoral Joint Morphological Abnormalities Predisposing to Patellar Instability and more. 1999;211:74753. 1993;21:2203. Objective: Patterns of bone bruise in knee injury. 10 0 obj On MR images, trabecular contusion has the appearance of bone marrow oedema. Call Us Today! HHS Vulnerability Disclosure, Help The classic bone contusion includes involvement of the antero-lateral aspect of the lateral femoral condyle and the inferomedial aspect of the patella. Arthroscopy. no significant difference in location for different type/ mode of injury. Posteromedial Tibial Bone Bruise After Anterior Cruciate Ligament Injury: An MRI Study of Bone Bruise Patterns in 208 Patients. Google Scholar. By directing imaging . Bone contusion is also noted in posterior lip of the medial tibial condyle [8] or medial femoral condyle and medial tibial condyle [7]. Patients with a knee MRI within one year of hyperextension injury were identified at our institution over a 7 year period. There has been limited investigation to subdividing the bone contusion model in the medial and lateral directions of the tibial plateau and the . The clip injury is a contact injury that occurs after a pure valgus stress is applied to the knee while the knee is in a state of mild flexion (i.e. The .gov means its official. Incidence and location of bone bruises after acute posterior cruciate ligament injury. Epub 2022 Mar 1. Nippon Igaku Hoshasen Gakkai Zasshi 55(6):375379, CAS Results are comparable to the study conducted by Kaplan et al., in which bone marrow contusion at posterior lip of medial tibial condyle was seen in 25 out of 215 cases (11.6%) and contusion in lateral compartment was noted in 24 out of 25 cases (96%) and contusion at medial femoral condyle was seen in 5 in 25 cases (20%) [7]. MR imaging performed in two patients with kissing contusions showed persistence of the tibial lesions. In this study, inclusion criteria were acute knee injury only in athletes while in our study there were no such selection criteria. The presence of a double sulcus showed significant association with anteromedial kissing contusions (OR = 7.8, p = 0.03). 2022 Oct;30(10):3508-3514. doi: 10.1007/s00167-022-06970-z. Surgical Strategy for Anterior Tibial Plateau Fractures in Hyperextension Knee Injuries. Objective: To determine the frequency, type, and distribution of kissing contusions occurring in association with injuries of the knee joint. Hyperextension injuries of the knee: do patterns of bone bruising Clin Orthop Relat Res. The .gov means its official. Google Scholar. CAS Results: Am J Sports Med. Our team of experienced agents will hand hold the member through theentireprocess. PubMed Pivot shift pattern is most common contusion pattern and the most common type/mode of injury is sports related injury. bone contusion) can give clues for the mechanism and associated injuries. Bone bruise, Compressisve force, Early degeneration, Microfracture, Torsional force. Federal government websites often end in .gov or .mil. Other structures are injured less frequently and have weaker associations with bone bruise distribution. Knee Surg Sports Traumatol Arthrosc 29(4):10181024, Cobby MJ, Schweitzer ME, Resnick D (1992) The deep lateral femoral notch: an indirect sign of a torn anterior cruciate ligament. bubble tea consumption statistics australia. Rangger C, Klestil T, Kathrein A, Indester A, Hamid L. Influence of magnetic resonance imaging on indications for arthroscopy of the knee. Bookshelf Am J Sports Med. Knee kinematics during noncontact anterior cruciate ligament injury as determined from bone bruise location. Bone contusion of the posterior lip of the medial tibial plateau (contrecoup injury) and associated internal derangements of the knee. MRI of the Pediatric Knee Pediatric Imaging Review. 2008;36:804. The datasets used or analysed during the current study are available from the corresponding author on reasonable request. uuid:a4a67e1a-1dd1-11b2-0a00-880000000000 Kapelov RS, Terris LM, Bradley WG, Bucciarelli NR, Murakami DM, Mullin WJ, et al. Orthop J Sports Med. Bone marrow contusion is transient dislocation of patella noted in anterior aspect of lateral femoral condyle and inferiomedial aspect of patella in all the cases (100 %). This study was approved by the ethical committee of Beijing Tsinghua Changgung Hospital (No. Analytical Services; Analytical Method Development and Validation Disabling symptoms are often prolonged. The .gov means its official. Meniscal injury was unrelated to the extent or pattern of bone bruising. Vojnosanit Pregl. 1030). Location of bone marrow contusion in hyperextension injury (4 cases) was - medial tibial and medial femoral condyle (2 cases) and anterior aspect of proximal tibia and femur (2cases). 2021 Jun;13(4):1343-1350. doi: 10.1111/os.12967. Bone marrow bruise is ill defined subchondral reticular or stellate region of low signal intensity on T1 and high signal intensity on T2W images [6]. bone bruises on magnetic resonance imaging evaluation of anterior cruciate ligament injuries. 6 Resident, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. Bone bruise represents as acute, occult microfractures of subchondral trabecular bone with subsequent haemorrhage, oedema and hyperemia. Bone bruise patterns in knee injuries: where are they found? <>/ExtGState<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/TrimBox[57.25999 58.11 666.34 848.69299]/Type/Page>> endstream Below is the link to the electronic supplementary material. MRIs, plain radiographs and clinical details of these patients were reviewed. Other 2 cases (50%) are hyperextension with valgus component and kissing contusion at medial aspect of proximal tibia and distal femur caused due to kicking while playing football. 1999 Jun;211(3):747-53 2 cases (50%) are hyperextension injury with kissing contusion at anterior aspect of proximal tibia and distal femur caused due to hit by car in RTA. Patel SA, Hageman J, Quatman CE, Wordeman SC, Hewett TE. By applying a biomechanical approach in MR interpretation, it is possible to detect lesions like ligament rupture and osseous contusion, to predict subtle but it might overlook important abnormalities. Arch Orthop Trauma Surg 128(11):13131316, Terzidis IP, Christodoulou AG, Ploumis AL, Metsovitis SR, Koimtzis M, Givissis P (2004) The appearance of kissing contusion in the acutely injured knee in the athletes. The relationship and characteristics between these two indicators was explored. In this study, the time gap between injury and doing MRI was not considered. Characteristic magnetic resonance imaging (MRI) findings often lead to the diagnosis. Please enable it to take advantage of the complete set of features! Matrix in various sequences were listed as : T1 Saggital 307 x 384, T2 Axial - 314 x 448, T2 Saggital 314 x 448, PD Saggital 307 x 384, PD Coronal 355 x 384, PDFS Saggital 288 x 384, PDFS Coronal 311 x 384, MEDIC Axial 240 x 320. In impaction, the compressive force directly strikes cortical bone and is dissipated into trabecular bone [4]. Article Magnetic Resonance Imaging of Bone Marrow: A Review Part II. Fornalski S, McGarry MH, Csintalan RP, Fithian DC, Lee TQ. In this case, patient has had a hyperextension external rotation injury of the knee as evidenced by the kissing bone marrow contusions in the anterior aspect of the lateral femoral condyle (LFC) and the lateral tibial plateau. Injury to the Meniscofemoral Portion of the Deep MCL Is Associated with Medial Femoral Condyle Bone Marrow Edema in ACL Ruptures. 2019. Correlation between contusion pattern in clip injury and type/mode of injury. Furthermore, it is anterior tibial oedema rather than the presence of kissing lesions than predicts cruciate ligament injury (OR = 10.5, p = 0.02). Among 46 cases, football was most common sports leading to injury followed by Kabaddi. J Comput Assist Tomogr. Price excludes VAT (USA) Contusion is seen in the anterior aspect of the distal femur and proximal tibia or located in medial femoral and tibial condyle (valgus force applied). Bone bruising of the knee. Boks et al., conducted a study of the natural course of bone bruises in posttraumatic knees and to describe possible determinants of this course and concluded that Median healing time of bone bruises is 42.1 weeks [5]. Bone bruises: MR characteristics and histological correlation in the young pig. Terzidis IP, Christodoulou AG, Ploumis AL, Metsovitis SR, Koimtzis M, Givissis P. The appearance of kissing contusion in the acutely injured knee in the athletes. of knee injury in pediatric patients. The usefulness of the oblique coronal plane in knee MRI on the evaluation of the posterior cruciate ligament. application/pdf Green DW, Hidalgo Perea S, Kelly AM, Potter HG. Correlation between type or mode of injury and patterns of bone marrow oedema was determined using p-value and chi-square method. Acta Radiol. In six cases (4.3%) no pattern of bone marrow contusion could be explained and was categorized as unclassified pattern [Table/Fig-6]. MeSH Background: They can be used to diagnose ACL injuries. On analysing the bone marrow contusion pattern, type/mode can be determined in most of cases. The secondary aims were to study bone marrow oedema patterns in setting of acute knee trauma, to associate the type of knee injury (from clinical history) with bone marrow oedema pattern, to determine the most common oedema pattern and to assess the most common type/mode of injury. Transient lateral patellar dislocation: review of imaging findings PDFS Saggital: Bone marrow oedema at Medial femoral and Medial tibial condyle in Hyperextension injury. Computed Tomography & Magnetic Resonance Imaging Of The Whole Body. Google Scholar. DOI: 10.1148/radiographics.20.suppl_1.g00oc19s135 PMID: 11046168. Kaplan PA, Gehl RH, Dussault RG, Anderson MW, Diduch DR. https://doi.org/10.1007/s00256-017-2754-y, https://doi.org/10.1016/j.arthro.2016.03.015. At the time the case was submitted for publication Henry Knipe had no recorded disclosures. Radiology. 2006;238:85362. Park HJ, Lee SY, Chung EC, Rho MH, Ahn JH, Kim M, et al. The Predicted Position of the Knee Near the Time of ACL Rupture Is Similar Between 2 Commonly Observed Patterns of Bone Bruising on MRI. Article PMC Epub 2021 Apr 4. Kessler R, Campbell S, Wong D, Mansfield LB. Knee Surg Sports Traumatol Arthrosc 26(5):13991405, Lodewijks P, Delawi D, Bollen TL, Dijkhuis GR, Wolterbeek N, Zijl JAC (2019) The lateral femoral notch sign: a reliable diagnostic measurement in acute anterior cruciate ligament injury. In many cases, Bone marrow contusion might have resolved at time of MRI. Pivot shift injury depending on location and type/mode of injury. 99 0 obj Bone bruising; Knee hyperextension; MRI. PubMed Central 2000;24:37180. It also was revealed that when the optimal cut-off point of LFNS was 0.72mm (area under the curve (AUC)=81%), the values of specificity and sensitivity were 67% and 84%, respectively. Radiology 182(1):221224, Niitsu M, Kuramochi M, Anno I, Itai Y (1995) Secondary signs of anterior cruciate ligament tear at MR imaging. PubMed PubMed Central Moderate edema at the gastrocnemius/soleus interface and overlying the superficial medial gastrocnemius proximal myotendinous junction. Epub 2013 Jun 6. While the knee is in a state of flexion, twisting motion of the knee can lead to transient dislocation of knee. Type/Mode of injury in these cases are: impact during car accident in 4 cases, fall on flexed knee while playing cricket in 1 case, while getting downstairs in 1 case and fall from bike in flexed knee in 2 cases. A deeper notch often indicates a more complex knee injury. A knee contusion can range from mild to severe. <> Our Facilities. Before Liu ZY, Zhang JL, Liu C, Cao Q, Shen QJ, Zhao JC. In total 200 cases, bone marrow contusion was noted in 138 cases (69%) and absent contusion in 62 cases (31%). XZ contributed to part of the statistics of the article. Study of Imaging Pattern in Bone Marrow Oedema in MRI in Recent Knee Book an Appointment. [101 0 R] Mechanism-based pattern approach to classification of complex injuries of the knee depicted at mr imaging. severe contusions may cause the knee to give out or lock. "Kissing contusion" refers to a bone contusion on both side of the knee joint. A cross-section study was done on all patients reffered to Krishna Hospital, Karad for MRI knee with history of recent (< 6 weeks) knee injury. Bone marrow contusion showed five patterns (according to Sanders classification) i.e., Clip injury in 39 cases (28.3%), Pivot shift injury in 78 cases (56.5%), Dashboard injury in eight cases (5.8%), Hyperextension injury in four cases (2.9%), Lateral patellar dislocation in three cases (2.2%). Bone marrow contusions are frequently identified at magnetic resonance imaging after an injury to the musculoskeletal system, and the mechanism of injury can be determined by studying the distribution of bone marrow edema, which enables one to predict with accuracy the specific soft-tissue abnormalities that are likely to be present. CAS Type/Mode of injury were twisting injury while getting downstairs (1 case), twisting injury while doing household work (1 case) and injury while playing football (1 case). Article Google Scholar. 1993 Mar-Apr;21(2):220-3 Waiving out of pocket expenses incentivizes your members to use the KISx network resulting in savings for both planandmember. (PDF) The appearance of kissing contusion in the acutely injured knee Semin Ultrasound CT MR. 1994 Oct;15(5):396-409. doi: 10.1016/s0887-2171(05)80006-x. This was comparable to study conducted by Kirsch et al., in who reported transient lateral patellar dislocation in 2% cases with acute knee injuries and bone marrow contusion is noted in lateral femoral condyle in 81% and contusion in patella in 19% cases [15]. PLT: Posterolateral tibial plateau, LF: Lateral femoral condyle, MT: Medial tibial condyle, MF: Medial femoral condyle. FOIA Part of Springer Nature. School of Clinical Medicine, Tsinghua University, Beijing, China, Peking University Third Hospital, Beijing, China, Beijing Tsinghua Changgung Hospital Affiliated To Tsinghua University, Beijing, China, Heng Gong,Xiaofei Zhang,Ligong Fu&Lianxu Chen, You can also search for this author in By directing imaging to outpatient sites, not hospital settings, it creates a better patient experience while yielding substantial savings. Bone marrow oedema is usually most prominent in the lateral femoral condyle secondary to the direct blow, whereas a second smaller area of oedema in the medial femoral condyle secondary to avulsive stress to the MCL. Careers, Unable to load your collection due to an error. PubMed To identify imaging pattern in bone marrow oedema and to correlate the pattern of bone marrow oedema retrospectively with type of knee injury from clinical history. 1989 Jun;171(3):761-6 Materials and methods: Among the 200 cases, bone marrow contusion was noted in 138 cases (69%) and absent contusion in 62 cases (31%). A prospective study of the association between bone contusion and intra-articular injuries associated with acute anterior cruciate ligament tear. Arndt WA, Traux AL, Baranett FM, Simmon GE, Brown DC. The site is secure. Whilst anterolateral tibial plateau oedema strongly predicted PCL injury [OR=26.0, p=0.003], ACL injury was associated with a variable pattern of bone bruising. 2016. https://doi.org/10.1016/j.arthro.2016.03.015. The coronal lateral collateral ligament sign in the anterior cruciate ligament-injured knees was observed regardless of the knee laxity based on the quantitative measurements. The 32 bone contusions (16 kissing contusions) were located as follows: lateral femoral condyle (n = 14; 8 type I, 6 type II); lateral tibial condyle (n = 9; 3 type I, 1 type II, 5 type III);. Orthopedic radiology Philadelphia, Pa: Saunders, 1986; 502, 511. 2000;28:6637. Unclassified injury pattern in 6 cases with type /mode of injury and location of bone marrow contusion. 5 Resident, Department of Radiology, Krishna Institute of Medical Science, Karad, Maharashtra, India. Five patterns of bone marrow contusion was noted in 138 cases: Clip injury in 39 cases (28.3%) [Table/Fig-1a&b], Pivot shift injury in 78 cases (56.5%) [Table/Fig-2a&b], Dashboard injury in eight cases (5.8%) [Table/Fig-3], Hyper extension injury in four cases (2.9%) [Table/Fig-4], Lateral patellar dislocation in three cases (2.2%) [Table/Fig-5]. Effusion in the adjacent deep infrapatellar bursa. endobj Shea KG, Archibald-Seiffer N, Murdock E, Grimm NL, Jacobs JC Jr, Willick S, Van Houten H. Knee injuries in downhill skiers: a 6-year survey study. Zeiss J, Paley K, Murray K, Saddemi SR. Herbst E, Hoser C, Tecklenburg K, Filipovic M, Dallapozza C, Herbort M, et al. Accessibility Mandalia V, Henson JH. Archives of Orthopaedic and Trauma Surgery, https://doi.org/10.1007/s00402-022-04366-9. A knee contusion is a bruised knee. Mechanisms of non-contact anterior cruciate ligament injury as - PubMed AJR Am J Roentgenol. For KC, the corresponding values were 36.6% and 99.4%, respectively. Twenty-five patients were identified (median time from injury to MRI = 24 days). Analysis of bone marrow oedema was done by a single observer based on MRI [9], its patterns were studied and possible type/mode of injury was determined before elucidating the history from the patient. It is not necessary to obtain consent. Follow up scan could not be done to establish the presumable diagnosis of bone marrow contusion. 36 0 obj We have included all the patients coming with acute knee injuries irrespective of type/mode of injury. Contusions of both surfaces of the joint are known as kissing contusions. In this study, patients with history of knee injury <6 weeks were considered as recent knee injuries. 2004;32:16817. This article about a disease of musculoskeletal and connective tissue is a stub. Knee Surg Sports Traumatol Arthrosc 23(8):22502258, Hoffelner T, Pichler I, Moroder P et al (2015) Segmentation of the lateral femoral notch sign with MRI using a new measurement technique. 2004-09-01T13:26:27Z The most common sites of bone bruising were the anteromedial tibial plateau (48%) and anterolateral tibial plateau (44%). The most common symptom of a knee contusion is pain. AJR Am J Roentgenol. Knee Surg Sports Traumatol Arthrosc. 2005;60:62736. Clipboard, Search History, and several other advanced features are temporarily unavailable. Pivot shift pattern is most common contusion pattern and the most common type/mode of sports related injury. 1998 Jun;69(3):291-4 2002;10:96101. Associated Soft tissue injuries include ACL and medial meniscus [8]. 1993;189:9014. 1989 Sep;27(5):983-1002 ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. J Clin Diagn Res. Increase in interstitial water content and hyperperfusion contributes to bone marrow oedema formation. Knee Surg Sports Traumatol Arthrosc 27(2):659664, Miller LS, Yu JS (2010) Radiographic indicators of acute ligament injuries of the knee: a mechanistic approach. Bone marrow oedema is responsible for patient symptoms and may lead to early degenerative changes [7]. Soft tissue abnormalities may include injury of ACL or PCL and a meniscal injury along with injury of the popliteal neurovascular structure, complete disruption of the posterolateral complex, gastrocnemius injury [8]. Google Scholar, Department of Orthopaedic Surgery, Chelsea and Westminster Hospital, London, UK, Department of Radiology, Chelsea and Westminster Hospital, London, UK, Department of Orthopaedic Surgery, Homerton University Hospital, London, UK, You can also search for this author in endobj -, Radiology. In present study transient dislocation of patella pattern is noted in 3 cases (2.2%). -, Am J Sports Med. Bisson LJ, Kluczynski MA, Hagstrom LS, Marzo JM. Clin Radiol. KIS Imaging is the nations largest direct contracting imaging network with over 2,600 providers covering all major imaging needs: MRI, CT and PET. Patient demographics, the clinical presentation, and the role of trauma are critical for . No significant difference was noted in location of bone marrow contusion in clip injury for different type/mode of injury. 5 out of 8 patients with a 'double sulcus' on the lateral radiograph had ACL injury. Looking for more information? Tax calculation will be finalised during checkout. Follow-up of occult bone lesions detected at MR imaging: systematic review. Br J Sports Med. volume47,pages 173179 (2018)Cite this article. After knee injury, bone marrow oedema is frequently subchondral in location and may be associated with either trabecular or cortically based lines [4]. Pattern of marrow oedema as per classification. {"url":"/signup-modal-props.json?lang=us"}, Knipe H, Yap J, Al Kabbani A, et al. The knee may also be swollen and bruised. Conclusions: Following knee hyperextension, bone bruising patterns may be associated with cruciate ligament injury. Song GY, Zhang H, Wang QQ, Zhang J, Li Y, Feng H. Bone contusions after acute noncontact anterior cruciate ligament injury are associated with knee joint laxity, concomitant meniscal lesions, and anterolateral ligament abnormality. Asai K, Nakase J, Oshima T, Shimozaki K, Yoshimizu R, Tsuchiya H (2020) Partial resection of the infrapatellar fat pad during anterior cruciate ligament reconstruction has no effect on clinical outcomes including anterior knee pain. MRIs, plain radiographs and clinical details of these patients were reviewed. 2014 Feb;44(2):281-93. doi: 10.1007/s40279-013-0116-z. sharing sensitive information, make sure youre on a federal A 30-year-old woman with acute knee injury. Kissing contusion - Wikipedia If the knee is exposed to forces beyond its physiologic range, risk of injury to bone or soft tissue structures increases. In this study, inclusion criteria included history of knee injury within 6 weeks or suspected ACL injury [12]. KIS Imaging and kissing contusions of the lat-eral femoral condyle and medial tibial pla . Kissing contusion refers to the bone contusions in both femoral and tibial surfaces of the knee. Davies NH, Niall D, King LJ, Lavelle J, Healy JC. Journal of Clinical and Diagnostic Research : JCDR, Lateral tibial plateau and medial femoral condyle, Medial femoral condyle, Metadiaphysis femur, Medial femoral condyle, proximal tibia and head. Radiology 219(3):800801, Ra H, Kim J, Lee D (2020) Comparative clinical outcomes of anterolateral ligament reconstruction versus lateral extra-articular tenodesis in combination with anterior cruciate ligament reconstruction: systematic review and meta-analysis. Correspondence to 2016 Nov;32(11):2331-2341 Objective: An official website of the United States government. 1996;198:2058. Exclusion criteria were history of any infection, surgery or neoplasm of knee joint, patients having any prosthetic heart valve implant, any pacemaker implant, aortic stent graft, cochlear implant or any metallic orthopedic implants, any joint replacement surgery and claustrophobic patients. Radiology 193(3):835840, Grimberg A, Shirazian H, Torshizy H, Smitaman E, Chang EY, Resnick DL (2015) Deep lateral notch sign and double notch sign in complete tears of the anterior cruciate ligament: MR imaging evaluation. These lesions also referred to as bone bruises, are presumably the result of microfracture of the medullar trabecula [5]. This injury most commonly occurs when the knee strikes against the dashboard during an automobile accident or fall against the ground on flexed knee.
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