Stump entrapment of the anterior cruciate ligament in late childhood and adolescence

ArticleinPediatric Radiology 41(8):1040-6 · August 2011with5 Reads
DOI: 10.1007/s00247-010-1969-z · Source: PubMed
Abstract
Displacement of a portion of the torn anterior cruciate ligament (ACL) into the intercondylar notch can cause a focal fibrotic reaction similar to that seen following ACL reconstruction. This displacement, which can result in locking or limitation of knee extension, is termed stump entrapment and is described in adult MR imaging literature. We present a pictorial essay of the etiology and appearance of stump entrapment on MR imaging of the knee in an older child and adolescents and review the significance of this finding.
  • [Show abstract] [Hide abstract] ABSTRACT: Laser diagnostic techniques have for more than 30 years added very valuable input for a deepened understanding of combustion processes. The present paper will focus on techniques developed for visualization of important parameters with the ability to get detailed information in space and time. The paper is not meant to be a complete review of the entire research field but rather a survey with a majority of the contributions from the authors’ laboratory. After a short introduction and background, essentially three techniques will be highlighted. Planar Laser-Induced Fluorescence, PLIF, will be described in terms of further development directed towards the use of a high-power Alexandrite laser, in some cases yielding a substantially increased sensitivity as compared to the more conventional Nd:YAG and Excimer lasers. There will also be a description of possibilities for high-speed visualization, 3D imaging and the potential to visualize species requiring a two-photon excitation process. Regarding thermometry, the paper will describe and exemplify the use of Thermographic Phosphors, mainly for surface measurements but also in droplets and gas flows. The third area to be described is the use of Polarization Spectroscopy, PS, for spatially and temporally resolved measurements in the IR spectral region, e.g. CO2 and H2O, various hydrocarbons, HCl and HCN. The last chapter focuses on present challenges and future applications. A major challenge is diagnostics in environments with limited optical access. Two methods that are applicable under such conditions are discussed, namely endoscopic approaches and picosecond LIDAR. Another challenging area addressed is application of diagnostics in optically dense environments, e.g. sprays, where a new technique, Structured Laser Illumination Planar Imaging, SLIPI, has been developed for suppressing the influence of multiple scattering. Finally, approaches for measurements of “new” species, challenges associated with LIF quantification, as well as measurements in environments possessing strong background radiation are discussed.
    Article · Dec 2011
  • [Show abstract] [Hide abstract] ABSTRACT: Imaging of the anterior cruciate ligament (ACL) requires adequate understanding of the unique structural features of the pediatric skeleton, the injury patterns as they relate to skeletal maturity, and the specific mechanisms of trauma. Magnetic resonance (MR) imaging is the preferred modality for the evaluation of the ACL because it allows characterization of ligamentous abnormalities and associated injuries without exposing the child to ionizing radiation. This article describes the normal appearance, primary, and secondary imaging findings of ACL injuries in children, and related traumatic lesions of the knee.
    Article · Oct 2011
  • [Show abstract] [Hide abstract] ABSTRACT: Objective Objective of this study was to determine the relationship between development of stump entrapment (SE) lesions and associated injuries in patients with knee extension deficits who underwent anterior cruciate ligament (ACL) reconstruction surgery. Materials and methods This retrospective study included 79 patients who had an arthroscopy-proven ACL rupture causing knee extension loss. Presence and type of the SE lesions, injuries of collateral-cruciate ligaments and bones, and tears of the menisci were evaluated and recorded on magnetic resonance imaging. Results The SE lesions were significantly more common in patients who had compressive posterior lateral tibial plateau fractures, tibia medial plateau edema and medial collateral ligament (MCL) injuries compared to the patients without stump lesions (p < 0.05). Posterior cruciate ligament (PCL) partial tears or sprains were significantly more common in patients with SE 1 lesions compared to the patients with SE 2 lesions (OR = 6.72; 95 % CI: 1.56–28.93). Conclusion SE is significantly more common in patients with compressive posterior lateral tibial plateau fractures, tibia medial plateau edemas and MCL injuries. PCL injury is more common in patients with type 1 SE.
    Article · Jun 2016