title: Posteromedial tibial plateau injury including avulsion fracture of the semimembranous tendon insertion site: ancillary sign of anterior cruciate ligament tear at MR imaging.
abstract: OBJECTIVE
  To evaluate posteromedial tibial plateau injuries of or about the semimembranous tendon insertion site and their association with anterior cruciate ligament (ACL) tears on magnetic resonance (MR) images.
  
  
  METHODS
  A retrospective study of MR images and conventional radiographs was performed in 10 patients with posteromedial tibial plateau injuries, including avulsion fractures of the semimembranous tendon insertion site. Associated abnormalities were analyzed, including ACL tears, medial meniscal tears, and other lateral femorotibial compartment injuries. Findings from the clinical history and physical examination were correlated with radiographic and MR imaging findings. Nine patients had arthroscopically or surgically documented ACL tears.
  
  
  RESULTS
  All 10 patients had ACL tears at MR imaging. Five patients had posteromedial tibial plateau fractures: Four had avulsion fractures of the tendon insertion site, and one had a fracture lateral to the site. Five patients had posteromedial tibial plateau bruises: Two had bruises at the tendon insertion site. Five patients had tears of the posterior horn of the medial meniscus. Two patients had posterior meniscocapsular separations. Three patients showed evidence of the O'Donoghue triad. Six patients had bruises of the lateral tibial plateau and of the lateral femoral condyle.
  
  
  CONCLUSIONS
  There appears to be an association between posteromedial tibial plateau injuries and ACL tears. Posteromedial tibial plateau injuries may be predictive of ACL status.
authors.affiliation: Department of Radiology, School of Medicine, University of California, San Diego Medical Center, USA.
authors.forename: K K
authors.initials: KK
authors.lastname: Chan
authors.forename: D
authors.initials: D
authors.lastname: Resnick
authors.forename: D
authors.initials: D
authors.lastname: Goodwin
authors.forename: L L
authors.initials: LL
authors.lastname: Seeger
mesh_terms: D000293:Adolescent; D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D013708:Tendon Injuries; D013977:Tibia / Q000293:injuries*; D000070600:Tibial Meniscus Injuries