Musculoskeletal imaging: double PCL sign: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Musculoskeletal imaging: double PCL sign

Sample item

After a twisting injury, a young footballer has a knee locked in flexion. Sagittal MRI shows a second low-signal band lying parallel and anterior to the posterior cruciate ligament. What is the injury?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Bucket-handle tear of the medial meniscus with a displaced fragment

A displaced bucket-handle fragment flips into the intercondylar notch and lies beside the PCL, producing the double PCL sign and a mechanically locked knee. ACL rupture leaves an abnormal ligament and a bone bruise pattern. The fragment is usually repaired or resected.

Option by option

  • A. Posterior cruciate ligament rupture

    A PCL rupture shows a disrupted ligament, not a duplicate.

  • B. Bucket-handle tear of the medial meniscus with a displaced fragment (correct)

    Correct. The double PCL sign is a displaced bucket-handle meniscal tear.

  • C. Patellar tendon rupture

    A patellar tendon rupture occurs in the extensor mechanism.

  • D. Complete ACL rupture

    ACL rupture does not create a second band beside the PCL.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is B, Bucket-handle tear of the medial meniscus with a displaced fragment. A displaced bucket-handle fragment flips into the intercondylar notch and lies beside the PCL, producing the double PCL sign and a mechanically locked knee.

Why is "Posterior cruciate ligament rupture" not the answer?

A PCL rupture shows a disrupted ligament, not a duplicate.

Why is "Patellar tendon rupture" not the answer?

A patellar tendon rupture occurs in the extensor mechanism.

Why is "Complete ACL rupture" not the answer?

ACL rupture does not create a second band beside the PCL.

What concept does this question test?

It tests Musculoskeletal imaging: double PCL sign in Radiology. ACL rupture leaves an abnormal ligament and a bone bruise pattern. The fragment is usually repaired or resected.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Musculoskeletal imaging: double PCL sign?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.