Last Updated: 2013-04-29
Injury typified by sudden, painful, audible pop noise. Patient typically presents with inability to return to activity, joint instability, and rapid development of effusion (hemarthrosis).
Often tender at lateral femoral condyle, lateral tibial plateau, and tibiofemoral joint lines.
A positive Lachman test is most accurate right after the injury and the pivot shift test is more useful in subacute or chronic cases.
History and physical usually provide accurate diagnosis.
X-rays obtained to rule out avulsion fractures or other related conditions, but do not directly identify ACL injury. MRI delineates ACL tears nicely, along with associated injury to menisci and other structures.
Initial treatment for most patients consists of protection, rest, ice, compression, elevation, and analgesia (as appropriate). Subsequent treatment varies by an individual patient's health and fitness status and goals. Treatment may range from minimal or no additional intervention to bracing, physical therapy, and activity modification, and to surgical reconstruction (either early or delayed).
T1-weighted MRI showing ACL tear
From the collection of Philip H. Cohen
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