Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 8/2011

01-08-2011 | Knee

The double ACL sign: an unusual bucket-handle tear of medial meniscus

Authors: Koji Takayama, Takehiko Matsushita, Tomoyuki Matsumoto, Seiji Kubo, Masahiro Kurosaka, Ryosuke Kuroda

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 8/2011

Login to get access

Abstract

Several characteristic magnetic resonance imaging (MRI) signs of meniscal bucket-handle tears are well known and widely used. This case report presents a new MRI sign of a meniscal bucket-handle tear. A 17-year-old boy visited our hospital because of the pain in his left knee. Preoperative MRI on sagittal view showed a tear in the anterior horn of the medial meniscus and a displaced fragment of the medial meniscus in front of the original anterior cruciate ligament (ACL), which looks like another ACL. Under arthroscopic examination, the bucket-handle medial meniscus displaced parallel to the ACL was observed. A longitudinal tear was extended from the anterior horn to the posterior horn of medial meniscus. To our knowledge, this new MRI sign of bucket-handle tear, “the double ACL sign”, has not been previously reported. Level of evidence V.
Literature
1.
go back to reference Aydingoz U, Firat AK, Atay OA, Doral MN (2003) MR imaging of meniscal bucket-handle tears: a review of signs and their relation to arthroscopic classification. Eur Radiol 13:618–625PubMed Aydingoz U, Firat AK, Atay OA, Doral MN (2003) MR imaging of meniscal bucket-handle tears: a review of signs and their relation to arthroscopic classification. Eur Radiol 13:618–625PubMed
2.
go back to reference Dandy DJ (1990) The arthroscopic anatomy of symptomatic meniscal lesions. J Bone Joint Surg Br 72:628–633PubMed Dandy DJ (1990) The arthroscopic anatomy of symptomatic meniscal lesions. J Bone Joint Surg Br 72:628–633PubMed
3.
go back to reference Fischer SP, Fox JM, Del Pizzo W, Friedman MJ, Snyder SJ, Ferkel RD (1991) Accuracy of diagnoses from magnetic resonance imaging of the knee. A multi-center analysis of one thousand and fourteen patients. J Bone Joint Surg Am 73:2–10PubMed Fischer SP, Fox JM, Del Pizzo W, Friedman MJ, Snyder SJ, Ferkel RD (1991) Accuracy of diagnoses from magnetic resonance imaging of the knee. A multi-center analysis of one thousand and fourteen patients. J Bone Joint Surg Am 73:2–10PubMed
4.
go back to reference Haramati N, Staron RB, Rubin S, Shreck EH, Feldman F, Kiernan H (1993) The flipped meniscus sign. Skeletal Radiol 22:273–277PubMedCrossRef Haramati N, Staron RB, Rubin S, Shreck EH, Feldman F, Kiernan H (1993) The flipped meniscus sign. Skeletal Radiol 22:273–277PubMedCrossRef
5.
go back to reference Helms CA, Laorr A, Cannon WD Jr (1998) The absent bow tie sign in bucket-handle tears of the menisci in the knee. AJR Am J Roentgenol 170:57–61PubMed Helms CA, Laorr A, Cannon WD Jr (1998) The absent bow tie sign in bucket-handle tears of the menisci in the knee. AJR Am J Roentgenol 170:57–61PubMed
6.
go back to reference Jackson DW, Jennings LD, Maywood RM, Berger PE (1988) Magnetic resonance imaging of the knee. Am J Sports Med 16:29–38PubMedCrossRef Jackson DW, Jennings LD, Maywood RM, Berger PE (1988) Magnetic resonance imaging of the knee. Am J Sports Med 16:29–38PubMedCrossRef
7.
go back to reference Kakel R, Russell R, VanHeerden P (2010) The triple PCL sign: bucket handle tears of both medial and lateral menisci in a chronically ACL-deficient knee. Orthopedics 33:772PubMed Kakel R, Russell R, VanHeerden P (2010) The triple PCL sign: bucket handle tears of both medial and lateral menisci in a chronically ACL-deficient knee. Orthopedics 33:772PubMed
8.
9.
go back to reference Poehling GG, Ruch DS, Chabon SJ (1990) The landscape of meniscal injuries. Clin Sports Med 9:539–549PubMed Poehling GG, Ruch DS, Chabon SJ (1990) The landscape of meniscal injuries. Clin Sports Med 9:539–549PubMed
10.
go back to reference Polly DW Jr, Callaghan JJ, Sikes RA, McCabe JM, McMahon K, Savory CG (1988) The accuracy of selective magnetic resonance imaging compared with the findings of arthroscopy of the knee. J Bone Joint Surg Am 70:192–198PubMed Polly DW Jr, Callaghan JJ, Sikes RA, McCabe JM, McMahon K, Savory CG (1988) The accuracy of selective magnetic resonance imaging compared with the findings of arthroscopy of the knee. J Bone Joint Surg Am 70:192–198PubMed
11.
go back to reference Reicher MA, Hartzman S, Duckwiler GR, Bassett LW, Anderson LJ, Gold RH (1986) Meniscal injuries: detection using MR imaging. Radiology 159:753–757PubMed Reicher MA, Hartzman S, Duckwiler GR, Bassett LW, Anderson LJ, Gold RH (1986) Meniscal injuries: detection using MR imaging. Radiology 159:753–757PubMed
12.
go back to reference Ruff C, Weingardt JP, Russ PD, Kilcoyne RF (1998) MR imaging patterns of displaced meniscus injuries of the knee. AJR Am J Roentgenol 170:63–67PubMed Ruff C, Weingardt JP, Russ PD, Kilcoyne RF (1998) MR imaging patterns of displaced meniscus injuries of the knee. AJR Am J Roentgenol 170:63–67PubMed
13.
go back to reference Shakespeare DT, Rigby HS (1983) The bucket-handle tear of the meniscus. A clinical and arthrographic study. J Bone Joint Surg Br 65:383–387PubMed Shakespeare DT, Rigby HS (1983) The bucket-handle tear of the meniscus. A clinical and arthrographic study. J Bone Joint Surg Br 65:383–387PubMed
14.
go back to reference Silva I Jr, Silver DM (1988) Tears of the meniscus as revealed by magnetic resonance imaging. J Bone Joint Surg Am 70:199–202PubMed Silva I Jr, Silver DM (1988) Tears of the meniscus as revealed by magnetic resonance imaging. J Bone Joint Surg Am 70:199–202PubMed
15.
go back to reference Singson RD, Feldman F, Staron R, Kiernan H (1991) MR imaging of displaced bucket-handle tear of the medial meniscus. AJR Am J Roentgenol 156:121–124PubMed Singson RD, Feldman F, Staron R, Kiernan H (1991) MR imaging of displaced bucket-handle tear of the medial meniscus. AJR Am J Roentgenol 156:121–124PubMed
16.
go back to reference Terzidis IP, Christodoulou A, Ploumis A, Givissis P, Natsis K, Koimtzis M (2006) Meniscal tear characteristics in young athletes with a stable knee: arthroscopic evaluation. Am J Sports Med 34:1170–1175PubMedCrossRef Terzidis IP, Christodoulou A, Ploumis A, Givissis P, Natsis K, Koimtzis M (2006) Meniscal tear characteristics in young athletes with a stable knee: arthroscopic evaluation. Am J Sports Med 34:1170–1175PubMedCrossRef
17.
go back to reference Ververidis AN, Verettas DA, Kazakos KJ, Tilkeridis CE, Chatzipapas CN (2006) Meniscal bucket handle tears: a retrospective study of arthroscopy and the relation to MRI. Knee Surg Sports Traumatol Arthrosc 14:343–349PubMedCrossRef Ververidis AN, Verettas DA, Kazakos KJ, Tilkeridis CE, Chatzipapas CN (2006) Meniscal bucket handle tears: a retrospective study of arthroscopy and the relation to MRI. Knee Surg Sports Traumatol Arthrosc 14:343–349PubMedCrossRef
18.
go back to reference Watt AJ, Halliday T, Raby N (2000) The value of the absent bow tie sign in MRI of bucket-handle tears. Clin Radiol 55:622–626PubMedCrossRef Watt AJ, Halliday T, Raby N (2000) The value of the absent bow tie sign in MRI of bucket-handle tears. Clin Radiol 55:622–626PubMedCrossRef
19.
go back to reference Weiss KL, Morehouse HT, Levy IM (1991) Sagittal MR images of the knee: a low-signal band parallel to the posterior cruciate ligament caused by a displaced bucket-handle tear. AJR Am J Roentgenol 156:117–119PubMed Weiss KL, Morehouse HT, Levy IM (1991) Sagittal MR images of the knee: a low-signal band parallel to the posterior cruciate ligament caused by a displaced bucket-handle tear. AJR Am J Roentgenol 156:117–119PubMed
20.
go back to reference Wright DH, De Smet AA, Norris M (1995) Bucket-handle tears of the medial and lateral menisci of the knee: value of MR imaging in detecting displaced fragments. AJR Am J Roentgenol 165:621–625PubMed Wright DH, De Smet AA, Norris M (1995) Bucket-handle tears of the medial and lateral menisci of the knee: value of MR imaging in detecting displaced fragments. AJR Am J Roentgenol 165:621–625PubMed
21.
go back to reference Yoo JH, Hahn SH, Yi SR, Kim SW (2007) Posterior double PCL sign: a case report of unusual MRI finding of bucket-handle tear of medial meniscus. Knee Surg Sports Traumatol Arthrosc 15:1343–1345PubMedCrossRef Yoo JH, Hahn SH, Yi SR, Kim SW (2007) Posterior double PCL sign: a case report of unusual MRI finding of bucket-handle tear of medial meniscus. Knee Surg Sports Traumatol Arthrosc 15:1343–1345PubMedCrossRef
Metadata
Title
The double ACL sign: an unusual bucket-handle tear of medial meniscus
Authors
Koji Takayama
Takehiko Matsushita
Tomoyuki Matsumoto
Seiji Kubo
Masahiro Kurosaka
Ryosuke Kuroda
Publication date
01-08-2011
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 8/2011
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-011-1441-0

Other articles of this Issue 8/2011

Knee Surgery, Sports Traumatology, Arthroscopy 8/2011 Go to the issue