Volume 20 No 8 (2022)
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Anatomy of the posterolateral corner of the knee on MRI: Normal and Abnormal
Eman Abd Elwahab Mosilhy, Ayman Fathy Zaid, Rania Mostafa Almolla, and Ahmed Mostafa Elmaghraby
Abstract
Specific components of the posterolateral corner that can be identified on MRI, albeit
with some variability, are the biceps femoris tendon, the fibular collateral ligament, the popliteus
musculotendinous complex including the popliteofibular ligament, the fabellofibular ligament, and
the arcuate ligament. In general, these normally low-signal-intensity structures are defined as
"sprain" when there is thickening and intermediate signal intensity within the structure on fatsuppressed fast spin-echo T2-weighted images and as torn when the structure is discontinuous with
a visible gap. Some researchers support the use of a coronal oblique plane of imaging to improve
visualization of some of the finer, obliquely oriented structures of the posterolateral corner,
including the popliteofibular, arcuate, and fabellofibular ligaments, although this has not become
routine. Recognition of bone marrow changes in thefibular head, including the so called “arcuate”
fracture that may also be seen on radiographs is also helpful in diagnosing posterolateral corner
injury. Being aware of the normal and abnormal MRI appearances of the structures of the
posterolateral corner of the knee and of the patterns of injury often seen in patients with
posterolateral corner rotatory instability will help radiologists suggest the diagnosis of
posterolateral corner injury even when not clinically suspected. This diagnosis is especially
important in the setting of combined injuries because unrecognized and unaddressed posterolateral
corner injuries may contribute significantly to ACL and PCL graft failure.
Keywords
posterolateral corner, Knee,MRI
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