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The rupture of the anterior cruciate ligament (ACL) in bell clapper is a rare ACL injury often overlooked.
Its diagnosis is clinical:
It is the presence of a flexion contracture of the knee (difficulty soft knee) often painful and irreducible. Usually present from the accident but sometimes after a free interval.
It is important to emphasize the role of MRI for radiological diagnosis with an aspect of "clapper" forward in the notch.
The treatment is always surgical. It involves removal of the ACL stump (clapper) by arthrolysis sub-arthroscopy associated with an ACL graft in the same operation (hamstring or KJ).
There is no proper epidemiological factor to damage the anterior cruciate ligament in bell clapper. Few studies in the literature available on the subject. The only epidemiological factor found in the literature is the frequency of partial ACL tears.
The main objective of this study was to present a synthesis of the current literature in order to provide a useful tool for clinicians in radiological analysis of the meniscus. The magnetic resonance imaging (MRI) is the most accurate and least invasive for the diagnosis of meniscal tears. This technique has revolutionized the imaging of the knee and has become the "gold standard" for imaging the meniscus. It confirms and characterize the meniscal lesion, type, extension, its possible association with a cyst meniscal extrusion, assessment of cartilage and subchondral bone. All anatomical descriptions were clearly illustrated in this articleby MRI, arthroscopic and / or drawings. We also described standard radiography for differential diagnosis as osteoarthritis. Ultrasound is often used as a diagnostic tool for meniscal pathology. CT arthrography with multiplanar reconstructions can detect some cracks not visible meniscus on MRI. CT arthrography is also useful in case of against-MRI in the postoperative evaluation of meniscal sutures or for analysis cartilage covering the articular surfaces.
MRI is the most accurate and least invasive method for the diagnosis of meniscal tears.New 3D MRI in three dimensions with isotropic resolution allow creating multiplanar reformatted images to obtain from an acquisition in one sectional plane, reconstructions in other spatial planes. 3D MRI should further improve the diagnosis of meniscal tears
This article describes MRI imaging of all meniscal lesions.