Association between traumatic bone marrow abnormalities of the knee, the trauma mechanism and associated soft-tissue knee injuries.
OBJECTIVE
To determine the association between traumatic bone marrow abnormalities, the knee injury mechanism, and associated soft tissue injuries in a larger cohort than those in the published literature.


METHODS
Retrospective study including 220 patients with traumatic knee injuries. Knee MRIs were evaluated for trauma mechanism, soft tissue injury, and the location of bone marrow abnormalities. The locations of the abnormalities were correlated with trauma mechanisms and soft tissue injuries using the chi-square test with Bonferroni correction.


RESULTS
One hundred and forty-four valgus injuries, 39 pivot shift injuries, 25 lateral patellar dislocations, 8 hyperextensions, and 4 dashboard injuries were included. Valgus and pivot shift injuries showed traumatic bone marrow abnormalities in the posterolateral regions of the tibia. Abnormalities after patellar dislocation were found in the anterolateral and centrolateral femur and patella. Hyperextension injuries were associated with abnormalities in almost all regions, and dashboard injuries were associated with changes in the anterior regions of the tibia and femur.


CONCLUSIONS
Our study provides evidence of associations between traumatic bone marrow abnormality patterns and different trauma mechanisms in acute knee injury, and reveals some overlap, especially of the two most common trauma mechanisms (valgus and pivot shift), in a large patient cohort.


CONCLUSIONS
• Specific bone marrow oedema patterns after knee trauma were confirmed. • New associations between bone marrow oedema patterns and knee trauma were shown. • Bone marrow oedema patterns help in identifying associated soft tissue injuries.
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Ramistrasse 100, CH - 8091, Zurich, Switzerland. nicole.berger@usz.ch.|Department of Forensic Medicine and Radiology, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland. nicole.berger@usz.ch.
Nicole
N
Berger
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Ramistrasse 100, CH - 8091, Zurich, Switzerland.
Gustav
G
Andreisek
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Ramistrasse 100, CH - 8091, Zurich, Switzerland.
Anissja T
AT
Karer
Department of Trauma Surgery, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland.
Samy
S
Bouaicha
Department of Medical Imaging, Mount Sinai Hospital and the University Health Network, University of Toronto, 600 University Ave, Toronto, ON, M5G 1X5, Canada.
Ali
A
Naraghi
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Ramistrasse 100, CH - 8091, Zurich, Switzerland.
Andrei
A
Manoliu
Epidemiology, Biostatistics and Prevention Institute, Department of Biostatistics, University of Zurich, Hirschengraben 84, 8001, Zurich, Switzerland.
Burkhardt
B
Seifert
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Ramistrasse 100, CH - 8091, Zurich, Switzerland.
Erika J
EJ
Ulbrich
D000293:Adolescent; D000328:Adult; D000368:Aged; D001853:Bone Marrow / Q000000981:diagnostic imaging* / Q000293:injuries*; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000150:complications* / Q000000981:diagnostic imaging*; D007719:Knee Joint / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
Bone bruise; Bone marrow oedema; Knee; Magnetic resonance imaging; Traumatic bone marrow abnormalities