Knee Injury

A 15-year-old footballer fell while playing soccer and sustained a twisting injury to his left knee. Post injury, he developed pain, swelling and locking of the left knee. He is unable to continue with the game. Clinical examination showed a moderate knee effusion. There was medial joint line tenderness. The anterior drawer is negative. The MRI of the knee is as shown. (Figure A and Figure B)

A. #14. What is the diagnosis? (2 marks)

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  Bucket handle (1 mark) tear of medial meniscus (1 mark)   
  https://en.wikipedia.org/wiki/Double_posterior_cruciate_ligament_sign 

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• B. #15. What is the sign demonstrated on the MRI in Fig B? (2 marks)

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  Double PCL sign.
  Student answer:  bowstring sign???, empty sulcus sign???
  
  
  

• C. #16. Name 4 other possible associated injuries in the knee. (4 marks)

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  Osteochondral injury
  

• ACL injury
  

• PCL injury
  

• Medial collateral ligament injury
  

• Lateral collateral ligament injury
  

• Lateral meniscus injury
  
  
  

• (Any 4, 1 mark each)

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• D. #17. What is the treatment for this injury? (2 marks)

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  Meniscus repair / Partial meniscectomy
  white-white, white-red, red-red zone