open access

Vol 78, No 3 (2019)
Review article
Submitted: 2018-12-11
Accepted: 2019-01-15
Published online: 2019-01-18
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Anatomical variations of knee ligaments in magnetic resonance imaging: pictorial essay

J. Tomczyk1, M. Rachalewski1, A. Bianek-Bodzak123, M. Domżalski4
·
Pubmed: 30664231
·
Folia Morphol 2019;78(3):467-475.
Affiliations
  1. Department of Radiology, Isotopic Diagnostic and Therapy, Military Medical Academy Teaching Hospital, Central Veteran Hospital, Lodz, Poland
  2. Department of Radiology, Medical University of Gdansk, Poland
  3. Department of Applied Medical Techniques, Medical University of Lodz, Poland
  4. Department of Orthopaedics, Traumatology and Post-traumatic Rehabilitation, Military Medical Academy Teaching Hospital, Central Veteran Hospital, Lodz, Poland

open access

Vol 78, No 3 (2019)
REVIEW ARTICLES
Submitted: 2018-12-11
Accepted: 2019-01-15
Published online: 2019-01-18

Abstract

Evaluation with magnetic resonance imaging (MRI) is currently a gold standard for comprehensive posttraumatic assessment of the knee joint. Increasing availability of MR systems with stronger magnetic fields and new sequences results in higher resolution of images and thus allows imaging smaller and finer anatomical details, including different anatomical variations.

This article focuses on anatomical variations of knee ligaments, which can mimics pathological structures. Well-known and less common ligaments that are sporadically observed and may raise the most doubt will be discussed. Familiarity with those variations of ligaments is indispensable for precise MRI reporting to avoid misinterpretation as meniscal tears, loose bodies or mass lesions especially in cases. This paper is addressed to both radiology and orthopaedics specialists. Illustrations show discussed ligaments in standard planes while, for less known ligaments, we add information on how to adjust planes to properly visualise a particular structure, which will hopefully facilitate finding and differentiating those structures in clinical practice.

Abstract

Evaluation with magnetic resonance imaging (MRI) is currently a gold standard for comprehensive posttraumatic assessment of the knee joint. Increasing availability of MR systems with stronger magnetic fields and new sequences results in higher resolution of images and thus allows imaging smaller and finer anatomical details, including different anatomical variations.

This article focuses on anatomical variations of knee ligaments, which can mimics pathological structures. Well-known and less common ligaments that are sporadically observed and may raise the most doubt will be discussed. Familiarity with those variations of ligaments is indispensable for precise MRI reporting to avoid misinterpretation as meniscal tears, loose bodies or mass lesions especially in cases. This paper is addressed to both radiology and orthopaedics specialists. Illustrations show discussed ligaments in standard planes while, for less known ligaments, we add information on how to adjust planes to properly visualise a particular structure, which will hopefully facilitate finding and differentiating those structures in clinical practice.

Get Citation

Keywords

knee; ligament; anatomical variation; magnetic resonance imaging

About this article
Title

Anatomical variations of knee ligaments in magnetic resonance imaging: pictorial essay

Journal

Folia Morphologica

Issue

Vol 78, No 3 (2019)

Article type

Review article

Pages

467-475

Published online

2019-01-18

Page views

2344

Article views/downloads

7534

DOI

10.5603/FM.a2019.0004

Pubmed

30664231

Bibliographic record

Folia Morphol 2019;78(3):467-475.

Keywords

knee
ligament
anatomical variation
magnetic resonance imaging

Authors

J. Tomczyk
M. Rachalewski
A. Bianek-Bodzak
M. Domżalski

References (35)
  1. Amis AA, Bull AMJ, Gupte CM, et al. Biomechanics of the PCL and related structures: posterolateral, posteromedial and meniscofemoral ligaments. Knee Surg Sports Traumatol Arthrosc. 2003; 11(5): 271–281.
  2. Amis AA, Gupte CM, Bull AMJ, et al. Anatomy of the posterior cruciate ligament and the meniscofemoral ligaments. Knee Surg Sports Traumatol Arthrosc. 2006; 14(3): 257–263.
  3. Bolog N, Hodler J. MR imaging of the posterolateral corner of the knee. Skeletal Radiol. 2007; 36(8): 715–728.
  4. Bozkurt M, Elhan A, Tekdemir I, et al. An anatomical study of the meniscofibular ligament. Knee Surg Sports Traumatol Arthrosc. 2004; 12(5): 429–433.
  5. Carpenter WA. Meniscofemoral ligament simulating tear of the lateral meniscus: MR features. J Comput Assist Tomogr. 1990; 14(6): 1033–1034.
  6. Chan CM, Goldblatt JP. Unilateral meniscomeniscal ligament. Orthopedics. 2012; 35(12): e1815–e1817.
  7. Cho JM, Suh JS, Na JB, et al. Variations in meniscofemoral ligaments at anatomical study and MR imaging. Skeletal Radiol. 1999; 28(4): 189–195.
  8. Dervin GF, Paterson RS. Oblique menisco-meniscal ligament of the knee. Arthroscopy. 1997; 13(3): 363–365.
  9. Edwards A, Bull AMJ, Amis AA. The attachments of the fiber bundles of the posterior cruciate ligament: an anatomic study. Arthroscopy. 2007; 23(3): 284–290.
  10. Ergün S, Karahan M, Akgün U, et al. [A case of multiple congenital anomalies including agenesis of the anterior cruciate ligament]. Acta Orthop Traumatol Turc. 2008; 42(5): 373–376.
  11. Gupte CM, Smith A, McDermott ID, et al. Meniscofemoral ligaments revisited. Anatomical study, age correlation and clinical implications. J Bone Joint Surg Br. 2002; 84(6): 846–851.
  12. Ishigooka H, Sugihara T, Shimizu K, et al. Anatomical study of the popliteofibular ligament and surrounding structures. J Orthop Sci. 2004; 9(1): 51–58.
  13. Kaelin A, Hulin PH, Carlioz H. Congenital aplasia of the cruciate ligaments. A report of six cases. J Bone Joint Surg Br. 1986; 68(5): 827–828.
  14. Kakel R, Russell R, VanHeerden P. The triple PCL sign: bucket handle tears of both medial and lateral menisci in a chronically ACL-deficient knee. Orthopedics. 2010; 33(10): 772.
  15. Kaplan EB. The lateral meniscofemoral ligament of the knee joint. Bull Hosp Joint Dis. 1956; 17(2): 176–182.
  16. Kato Y, Ingham SJM, Maeyama A, et al. Biomechanics of the human triple-bundle anterior cruciate ligament. Arthroscopy. 2012; 28(2): 247–254.
  17. Kim SJ, Kim DW, Min BH. Discoid lateral meniscus associated with anomalous insertion of the medial meniscus. Clin Orthop Relat Res. 1995(315): 234–237.
  18. Min BH, Ha HK, Khang SY. Medial discoid meniscus completely coalesced with the anterior cruciate ligament. Arthroscopy. 2001; 17(7): E27.
  19. Minowa T, Murakami G, Kura H, et al. Does the fabella contribute to the reinforcement of the posterolateral corner of the knee by inducing the development of associated ligaments? J Orthop Sci. 2004; 9(1): 59–65.
  20. Munshi M, Pretterklieber ML, Kwak S, et al. MR imaging, MR arthrography, and specimen correlation of the posterolateral corner of the knee: an anatomic study. AJR Am J Roentgenol. 2003; 180(4): 1095–1101.
  21. Nelson EW, LaPrade RF. The anterior intermeniscal ligament of the knee. An anatomic study. Am J Sports Med. 2000; 28(1): 74–76.
  22. Norwood LA, Cross MJ. Anterior cruciate ligament: functional anatomy of its bundles in rotatory instabilities. Am J Sports Med. 1979; 7(1): 23–26.
  23. Obaid H, Gartner L, Haydar AA, et al. The meniscofibular ligament: an MRI study. Eur J Radiol. 2010; 73(1): 159–161.
  24. Otsubo H, Shino K, Suzuki D, et al. The arrangement and the attachment areas of three ACL bundles. Knee Surg Sports Traumatol Arthrosc. 2012; 20(1): 127–134.
  25. Pfirrmann CWA, Zanetti M, Hodler J. Joint magnetic resonance imaging: normal variants and pitfalls related to sports injury. Radiol Clin North Am. 2002; 40(2): 167–180.
  26. Raheem O, Philpott J, Ryan W, et al. Anatomical variations in the anatomy of the posterolateral corner of the knee. Knee Surg Sports Traumatol Arthrosc. 2007; 15(7): 895–900.
  27. Recondo JA, Salvador E, Villanúa JA, et al. Lateral stabilizing structures of the knee: functional anatomy and injuries assessed with MR imaging. Radiographics. 2000; 20 Spec No: S91–S9S102.
  28. Sanders TG, Linares RC, Lawhorn KW, et al. Oblique meniscomeniscal ligament: another potential pitfall for a meniscal tear--anatomic description and appearance at MR imaging in three cases. Radiology. 1999; 213(1): 213–216.
  29. Seebacher JR, Inglis AE, Marshall JL, et al. The structure of the posterolateral aspect of the knee. J Bone Joint Surg Am. 1982; 64(4): 536–541.
  30. Sintzoff SA, Stallenberg B, Gillard I, et al. Transverse geniculate ligament of the knee: appearance and frequency on plain radiographs. Br J Radiol. 1992; 65(777): 766–768.
  31. Snoeckx A, Vanhoenacker FM, Gielen JL, et al. Magnetic resonance imaging of variants of the knee. Singapore Med J. 2008; 49(9): 734–744.
  32. Soejima T, Murakami H, Tanaka N, et al. Anteromedial meniscofemoral ligament. Arthroscopy. 2003; 19(1): 90–95.
  33. Tyler P, Datir A, Saifuddin A. Magnetic resonance imaging of anatomical variations in the knee. Part 1: ligamentous and musculotendinous. Skeletal Radiol. 2010; 39(12): 1161–1173.
  34. Venkatanarasimha N, Kamath A, Mukherjee K, et al. Potential pitfalls of a double PCL sign. Skeletal Radiol. 2009; 38(8): 735–739.
  35. Zivanović S. Menisco-meniscal ligaments of the human knee joint. Anat Anz. 1974; 135(1-2): 35–42.

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