Knee X-Ray and MRI

Grade I = minimal osteophytes w/ no problems w/ space or cartilage

Define the Kelgren Lawrence grade. How do you know?

Grade II = 1 definite osteophyte w/ NO space narrowing

Define the Kelgren Lawrence grade. How do you know?

Grade III = marginal osteophytes w/ space narrowing + sclerosis & multiple osteophytes

Define the Kelgren Lawrence grade. How do you know?

Grade IV = obliteration of joint space (bone on bone)

Define the Kelgren Lawrence grade. How do you know?

Comminuted patellar fracture

Define the pathology.

Tibial plateau fractures

Define the pathology.

Sub-chondral edema/bone bruise (HUGE influence on rehab!!)

Define the pathology.

Synovitis surrounding the joint

Define the pathology.

Bone edema/bone bruise

Define the pathology.

Bone edema/bone bruise

Define the pathology.

1. Hyaline cartilage (all of the grey)

2. Meniscus (looks kind of like a thickening of the cartilage from this angle)

Label 1 & 2.

1. Patellar tendon

2. Patella

3. Quadriceps tendon

4. Hoffa's fat pad

5. Retro-surface cartilage of patella

6. Quadriceps

7. Hamstrings

8. Gastroc.

9. Poplitus

Label 1-9.

ACL (always goes inferior --> superior in a posterior direction)

Which ligament can you see in this sagittal view?

1. Popliteal artery

2. Femur

3. Patella

Label 1-3.

Medial meniscus

Label this structure.

1. MCL

2. LCL

3. Medial meniscus

4. Hyaline cartilage of tibia & femur

5. ACL

Label 1-5.

A = healthy ACL running inferior & anterior to superior & posterior

B = fully torn ACL (since the ligament is laying down flat on the tibia, we know that it is a full tear...if it were a partial tear, it would just appear wavy)

What is the difference between image a and b?

Complete tear of the ACL (right down the middle)

Define the pathology.

Complete tear of the ACL

Define the pathology.

Tear of the ACL

Define the pathology.

Tear of the ACL

Define the pathology.

PCL (runs from posterior & inferior --> to anterior & superior)

Which structure is the white arrow pointing too?

Tear of the PCL -- normally, ligaments are pulled taut and appear straight; if they are torn, they appear wavy and/or curved over

Define the pathology. How do you know?

Tear of the PCL -- when ligaments curve like this and/or get wavey, it is a dead give-a-way that a tear is present

Define the pathology.

Grade III MCL tear

Define the pathology.

GOTCHA!! This is a NORMAL LCL!!

Define the pathology.

Torn LCL

Define the pathology. (#1 is just pointing to the meniscus)

Meniscus tear (the meniscus should look like a wedge)

Define the pathology.

Meniscus tear

Define the pathology.

Patellar tendinopathy ("Jumper's knee")

Define the pathology.

IT band-related lateral knee pain (cyst on the left image, some signal change on the right image)

Define the pathology.

Distal biceps femoris tendinopathy

Define the pathology.

Popliteus injury

Define the pathology.

Popliteus injury

Define the pathology.

Pes anserine bursitis

Define the pathology.