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Radiology · MSK imaging: knee MRI
Sample itemAfter a twisting football injury, a patient has a positive anterior drawer test, and MRI of the knee shows discontinuity of the ACL and a bone bruise pattern. Which bone bruise pattern is typical?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Lateral femoral condyle and posterolateral tibial plateau
In ACL rupture, the pivot-shift mechanism causes impaction of the lateral femoral condyle against the posterolateral tibial plateau, producing a characteristic kissing contusion pattern. A Segond fracture (avulsion of the lateral tibial plateau) is also associated. Patellar dislocation produces bruising of the medial patella and lateral femoral condyle.
Option by option
A. Patella and trochlea
Patella and trochlea bruising suggests patellar dislocation or contact injuries.
B. Tibial tubercle
Tibial tubercle changes suggest Osgood-Schlatter disease.
C. Medial femoral condyle only
Medial femoral bruise alone is not typical.
D. Lateral femoral condyle and posterolateral tibial plateau (correct)
Correct. Lateral femoral condyle with posterolateral tibial plateau bruising is typical.
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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