The deep medial femoral sulcus sign: does it exist?
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SCIENTIFIC ARTICLE
The deep medial femoral sulcus sign: does it exist? Robert D. Wissman 1 & Derek Stensby 1 & Juhi Koolwal 1 & Philip Silva 1 & Mojgan Golzy 2 Received: 27 July 2020 / Revised: 14 August 2020 / Accepted: 16 August 2020 # ISS 2020
Abstract Objective To determine the normal depth of the medial femoral sulcus on lateral radiographs of the knee and determine if abnormal deepening of the medial femoral sulcus exists as a radiographic indicator of intra-articular knee abnormalities. Materials and methods A retrospective search was performed over a period of 10 years to identify all individuals with a bone contusion of the anterior medial femoral condyle at MR imaging. Study patients had documented acute knee injuries and radiographs 6 weeks or less prior to their MR. A control group had normal MR exams and radiographs 6 weeks or less prior to their MR. Two fellowship-trained musculoskeletal radiologists independently measured the depth of the medial femoral sulcus on lateral radiographs blinded to control or study individuals. Results The study group consisted of 76 patients (57 men, 19 women; age range, 18–50 years; mean age, 27 years) and 92 control patients (33 men, 59 women; age range, 18–46 years; mean age 26 years). Sulcus depth was (0–2.3 mm reader 1 and 0–1.7 mm reader 2 for controls; 0–2.2 mm reader1 and 0–1.8 mm reader 2 for study patients). No significant difference in sulcus depth was identified between the control and study groups. Inter-reader agreement was very strong. The most common cause of injury in the study group was motor vehicle accidents followed by hyperextension and twisting injuries of the knee. Conclusion The normal medial femoral sulcus ranges in depth from 0 to 2.3 mm. Although impaction of the sulcus does occur following knee injuries, the sulcus does not deepen. Keywords MRI . Knee . Hyperextension . Sulcus . Notch . Medial femoral sulcus
Introduction The knee is one of the most commonly injured joints of the extremities, and plain film radiographs are often obtained as * Robert D. Wissman [email protected] Derek Stensby [email protected] Juhi Koolwal [email protected] Philip Silva [email protected] Mojgan Golzy [email protected] 1
Department of Radiology One Hospital Drive, University of Missouri Health Care, Columbia, MO 65212, USA
2
Department of Health Management and Informatics One Hospital Drive, University of Missouri Health Care, Columbia, MO 65212, USA
first-line imaging studies. Numerous radiographic plain film findings of the knee have been described which can alert the radiologist to critical internal derangements [1]. Many of these radiographic findings are highly sensitive as well as specific for ligamentous abnormalities. A common radiographic finding in anterior cruciate ligament (ACL) tears is a deep lateral femoral notch or deep lateral femoral sulcus [2]. The lateral femoral sulcus is an anatomic landmark commonly present on lateral radiographs of normal individuals. Following ACL disruption, ant
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