Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Skeletal Radiology
Published in: Skeletal Radiology 11/2003

01-11-2003 | Article

MR imaging of anterior cruciate ligament tears: is there a gender gap?

Authors: Laura M. Fayad, J. Antoni Parellada, Laurence Parker, Mark E. Schweitzer

Published in: Skeletal Radiology | Issue 11/2003

Login to get access

Abstract

Objective

Clinically, females receive anterior cruciate ligament (ACL) tears more commonly than males. We explored whether gender differences exist in MR imaging patterns of ACL tears.

Design and patients

At 1.5T, two observers evaluated MR examinations of 84 consecutive age-matched patients (42 males, 42 females, aged 16–39) with ACL tears, for mechanism of injury, extent and type of tear, the presence of secondary signs and associated osseous, meniscal and ligamentous injuries.

Results

The most common mechanism of injury for both females and males was the pivot shift mechanism (67 and 60%, respectively). Females were more commonly imaged in the acute stage of tear than males (98 and 67%, respectively, p=0.001) and more commonly possessed the typical posterolateral tibial bone contusion pattern (88 and 62%, respectively, p=0.0131). Males exhibited a deeper femoral notch sign (2.7 and 2.0 mm, p=0.007) and medial meniscal, lateral collateral ligament and posterior cruciate ligament injuries more commonly than females (48 and 24%, p=0.009, 30 and 7%, p=0.035, 17 and 0%, p=0.035). There was no significant difference between genders for the presence of other secondary signs and contusion patterns, associated lateral meniscal tears, presence of O'Donoghue's triad or associated medial collateral ligament injuries.

Conclusion

Gender differences in MR imaging patterns of ACL tears exist: females are more commonly imaged in the acute stage and more commonly possess posterolateral tibial bone contusions; males have a more severe presentation than females, associated with more severe lateral femoral condyle and soft tissue injuries.
Literature
1.
Huston LJ, Greenfield ML, Wojtys EM. Anterior cruciate ligament injuries in the female athlete: potential risk factors. Clin Orthop 2000; 372:50–63.PubMed
2.
Kirkendall DT, Garrett WE. The anterior cruciate ligament enigma: injury mechanisms and prevention. Clin Orthop 2000; 372:64–68.PubMed
3.
Lee K, Siegel MJ, Lau DM, Hildebolt CF, Matava MJ. Anterior cruciate ligament tears: MR imaging-based diagnosis in a pediatric population. Radiology 1999; 213:697–704.PubMed
4.
Arendt E, Dick R. Knee injury patterns among men and women in collegiate basketball and soccer: NCAA data and review of literature. Am J Sports Med 1995; 23:694–701.PubMed
5.
Henry JC, Kaeding C. Neuromuscular differences between male and female athletes. Curr Womens Health Rep 2001; 3:241–244.
6.
Hewett TE, Myer GD, Ford KR. Prevention of anterior cruciate ligament injuries. Curr Womens Health Rep 2001; 3:218–224.
7.
Medvecky MJ, Bosco J, Sherman OH. Gender disparity of anterior cruciate ligament injury: etiological theories in the female athlete. Bull Hosp Jt Dis 2000; 59(4):217–226.
8.
LaPrade RF, Burnett QM. Femoral intercondylar notch stenosis and correlation to anterior cruciate ligament injuries. A prospective study. Am J Sports Med 1994; 22(2):198–202.
9.
Anderson AF, Dome DC, Gautam S, Awh MH, Rennirt GW. Correlation of anthropometric measurements, strength, anterior cruciate ligament size and intercondylar notch characteristics to sex differences in anterior cruciate ligament tear rates. Am J Sports Med 2001; 29(1):58–66.
10.
Tillman MD, Smith KR, Bauer JA, Cauraugh JH, Falsetti AB, Pattishall JL. Differences in three intercondylar notch geometry indices between males and females: a cadaver study. The Knee 2002; 9:41–46.CrossRefPubMed
11.
Robertson PL, Schweitzer ME, Bartolozzi AR, Ugoni A. Anterior cruciate ligament tears: evaluation of multiple signs with MR imaging. Radiology 1994; 193:829–834.PubMed
12.
Remer EK, Fitzgerald SW, Friedman H, Rogers LF, Hendrix RW, Schafer MF. Anterior cruciate ligament injury: MR imaging diagnosis and patterns of injury. RadioGraphics 1992; 12:901–915.PubMed
13.
Mink JH, Levy T, Crues JV. Tears of the anterior cruciate ligament and menisci of the knee: MR imaging evaluation. Radiology 1988; 167:769–774.PubMed
14.
Cobby MJ, Schweitzer ME, Resnick D. The deep lateral femoral notch: an indirect sign of a torn anterior cruciate ligament. Radiology 1992; 184:855–858.PubMed
15.
Schweitzer ME, Cervilla V, Kursunoglu-Brahme S, Renick D. The PCL Line Sign: an indirect sign of anterior cruciate ligament injury. Clin Imaging 1992; 16:43–48.PubMed
16.
Brandser EA, Riley MA, Berbaum KS, El-Khoury GY, Bennett DL. MR imaging of anterior cruciate ligament injury: independent value of primary and secondary signs. AJR 1996; 167:121–126.PubMed
17.
Vahey TN, Broome DR, Kayes KJ, Shelbourne KD. Acute and chronic tears of the anterior cruciate ligament: differential features at MR imaging. Radiology 1991; 251–253.
18.
Dimond PM, Fadale PHD, Hulstyn MJ, Tung GA, Greisberg J. A comparison of MRI findings in patients with acute and chronic ACL tears. Am J Knee Surg 1998; 11(3):153–159.
19.
Sanders TG, Medynski MA, Feller JF, Lawhorn KW. Bone contusion patterns of the knee at MR imaging: footprint of the mechanism of injury. Radiographics 2000; 20:S135–S151.PubMed
20.
Hayes CW, Brigido MK, Jamadar MB, Propeck T. Mechanism-based pattern approach to classification of complex injuries of the knee depicted at MR imaging. RadioGraphics 2000; 20:S121–S134.PubMed
21.
Irizarry JM, Recht MP. MR imaging of knee ligament injuries. Radiol Clin North Am 1997; 35(1):45–76.
22.
Helms CA. The Meniscus: Recent Advances in MR Imaging of the Knee. AJR 2002; 179(5):1115–1122.
23.
Horton MG, Hall TL. Quadriceps femoris muscle angle: normal values and relationships with gender and selected skeletal measures. Phys Ther 1989; 69:897–901.PubMed
24.
Mafulli N, Binfield PM, King JB, Good CJ. Acute haemarthrosis of the knee in athletes. A prospective study of 106 cases. J Bone Joint Surg Br 1993; 75(6):945–949.
25.
Liu W, Maitland ME, Bell GD. A modeling study of partial ACL injury: simulated KT-2000 arthrometer tests. J Biomech Eng 2002; 124(3):294–301.
26.
Bendijaballah MZ, Chirazi-Adl A, Zukor DJ. Finite element analysis of human knee joint in varus-valgus. Clin Biomech 1997; 12:139–148.CrossRef
27.
Mink JH, Deutsch AL. Occult cartilage and bone injuries of the knee: detection, classification and assessment with MR imaging. Radiology 1989; 170:823–829.PubMed
28.
Weishaupt D, Schweitzer ME, DiCuccio MN, Whitley PE. Relationships of cervical, thoracic, and lumbar bone mineral density by quantitative CT. J Comput Assist Tomogr 2001; 25(1):146–150.
29.
Garrick JG. Epidemiology of the ACL. In: Feagin JA, ed. The crucial ligaments: diagnosis and treatment of ligamentous injuries about the knee. New York: Churchill Livingstone, 1988; 173–176.
30.
Shelbourne KD, Nitz PA. The O'Donoghue triad revisited. Combined knee injuries involving anterior cruciate and medial collateral ligament tears. Am J Sports Med 1991; 19(5):474–474.
31.
Bellabarba C, Bush-Joseph CA, Bach BR Jr. Patterns of meniscal injury in the anterior cruciate-deficient knee: a review of the literature. Am J Orthop 1997; 26(1):18–23.
32.
Cipolla M, Scala A, Gianni E, Puddu G. Different patterns of meniscal tears in acute anterior cruciate ligament (ACL) ruptures and in chronic ACL-deficient knees. Classification, staging and timing of treatment. Knee Surg Sports Traumatol Arthrosc 1995; 3(3):130–134.
33.
Schweitzer ME, Tran D, Deely DM, Hume EL. Medial collateral ligament injuries: evaluation of multiple signs, prevalence and location of associated bone bruises, and assessment with MR imaging. Radiology 1995; 194(3):825–829.
34.
Barry KP, Mesagarzadeh M, Moyer R, et al. Patterns and accuracy of diagnosis of anterior cruciate ligament tears with MR imaging. Radiology 1991; 181:303–307.
35.
Rose NE, Gold SM. A comparison of accuracy between clinical examination and magnetic resonance imaging in the diagnosis of meniscal and anterior cruciate ligament tears. Arthroscopy 1996; 12(4):398–405.
Metadata
Title
MR imaging of anterior cruciate ligament tears: is there a gender gap?
Authors
Laura M. Fayad
J. Antoni Parellada
Laurence Parker
Mark E. Schweitzer
Publication date
01-11-2003
Publisher
Springer-Verlag
Published in
Skeletal Radiology / Issue 11/2003
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-003-0694-1

Other articles of this Issue 11/2003

Skeletal Radiology 11/2003 Go to the issue

Article

Unilateral hypertrophy of tensor fascia lata: a soft tissue tumor simulator

Article

MR imaging for preoperative diagnosis and assessment of local tumor extent on localized giant cell tumor of tendon sheath

Case Report

Fibrolipomatous hamartoma in the foot: atypical MR imaging findings

Article

Arcuate sign of posterolateral knee injuries: anatomic, radiographic, and MR imaging data related to patterns of injury

Abstracts

Abstracts of the Special Scientific Session, ISS 2003

Case Report

Isolated intraosseous gout in hallux sesamoid mimicking a bone tumor in a teenaged patient