I know there is an ACL tear and Ramp lesion (not shown).
I am showing this to clarify the anatomy.
The FCL, ITB and Bic. Femoris appear intact in axial images.
There is soft tissue injury posterior to the ITB and superficial to the FCL
/ anterior to the Biceps.
Is this the lateral capsule, posterior fibers of the IT tract, deep fascia?
[image: Knee 61M fell 2 weeks ago.jpeg]
[image: Knee 61M fell 2 weeks ago 2.jpeg]
[image: Knee 61M fell 2 weeks ago 3.jpeg]
I received several immediate comments that the Anterior Lateral Ligament was torn,
though nobody responded to my direct questions about where the tear was.
I thought that Jack Porrino’s article was very well written, and it gently
walked me through the history of the Anterolateral Ligament….which seems
to me to be much ado about nothing new….now that I think I have a better
understanding.
I contacted Jack and he said that he couldn’t tell what was torn based on
the images I shared through OCAD (curious that so many others were so
certain), so I screen-shared with him and he talked me through the
anatomy. As in his article, he explained that the ALL is essentially the
middle third lateral capsular ligaments….what I’ve understood to be the
meniscofemoral and meniscotibial capsular ligaments.
I’ve attached additional images suggesting that meniscofemoral
ligament seems injured.
He thought that the anterior oblique ligament of the FCL might be injured.
I wondered if there was a name for the seemingly injured fibers posteriorly
and superficially, which seem torn, between the ITB and Biceps (do you
know)?
This ALL has inspired a flurry of creative writing in recent years….quite
incredible—-alot of news and fake news….the MSK radiology version of
the 24 hour news cycle—-I wonder weather we should vote to recall the ALL
and re-institute “middle third capsular ligament”.
I’ve attached a couple of additional composite images. As I understand
things…feel free to tell me I still have no idea what I’m talking about.
[image: 1.jpg]
[image: 2.jpg]
On Mon, Sep 13, 2021 at 11:02 AM hilary umans <hilary.umans@gmail.com>
wrote:
[gallery]