I received a handful of comments:
I would say the oedema highlights fascial layers you don’t usually see, rather than a co-existent MCL injury, which is less likely.
I would call the MCL intact with just minor surrounding edema
I would not call a delamination, just a sprain of the MCL.
I wonder if the red arrow may represent a thickened deep layer of the subcutaneous tissue/fascia that is being highlighted by the surrounding soft tissue edema.
Thank you for sharing this interesting case. I agree with your assessment of a distal delamination of the MCL.
Your observation about the importance of the deep MCL in these injuries is also very important. I have also seen cases where reinforcing the deep MCL has resulted in improved stability immediately intraoperatively, on the medial side, even before addressing the superficial MCL.
In most cases, it is not necessary to intervene on the superficial MCL unless there is a Stener lesion.
Thank you again for sharing this case. It is a good reminder to pay attention to the deep MCL in these injuries.
one of the anserinus pes tendons ? sartorius ?
I chose to report MCL sprain and medial pericapsular edema….with the meniscal root ligament tear and meniscal extrusion, it seems that the dMCL capsular injury is secondary….not going to "put the genie back into the bottle"
Thanks to all who commented.
Hilary
Subacute complete posterior horn medial meniscal root ligament tear (white arrow)
with extruded intact MM body
Smooth impaction of the medial tibial margin by the extruded meniscal body (I think we can sometimes see this on XR) with reaction marrow edema
No real Medial compartment cartilage loss..Yet…My question is about the MCL…would you call this distal delamination (red arrow)?
Great fortuitous look at the meniscal root tear in the axial, along with the intact MM
