rev bras ortop.2014;49(1):98–99
w w w . r b o . o r g . b r
Letter
to
the
Editor
The
anterolateral
ligament
of
the
knee
–
Visibility
on
magnetic
resonance
imaging
夽
Ligamento
anterolateral
do
joelho
–
visibilidade
na
ressonância
nuclear
magnética
DearEditor,
WithgreatinterestIhavereadthearticle“Anatomicalstudy
ontheanterolateralligamentoftheknee”inyourjournal.1
MeanwhileanothermorphologicalstudybyClaesetal.2also
reportedregularoccurrenceoftheanterolateralligamentof theknee.TogetherwiththedataofVincentetal.,thesethree studieshaveexamined57anatomicalspecimenandfoundthe anterolateralligamentin56ofthem(98.2%).1–3Giventhe
prob-ableclinicalimpactonoutcomeaftersurgeryoftheanterior cruciateligamentpreoperativejudgmentofitsintegritywould bedesirable.Tostudythevisibilityonstandardmagnetic res-onanceimaging(MRI)oftheknee30randomlyselectedknee MRIsfromthedepartmentalPACSwerereviewed(5women, 25men,meanage38.9years).Imagingwasperformedonan outpatientbasisusingdifferentscannerswithafieldstrength of1.0or1.5T.Accordingtothereportedlocalization ofthe anatomicstudies coronalimagesseemed mostappropriate
Trato iliotibial
Ligament an terolateral
Ligament colateral lateral
Fig.1–Coronalfat-suppressedT2-weightedimagingofa38-year-oldmaleaftertrauma.Theanterolateralligamentis arisingfromthefemurwithtwoinsertions,thelateralmeniscusandthetibia.Itislocateddorsaltotheiliotibialtractand ventraltothelateralcollateralligament.
夽
Pleasecitethisarticleas:GossnerJ.Ligamentoanterolateraldojoelho–visibilidadenaressonâncianuclearmagnética.RevBrasOrtop. 2014;49:98–99.
for depiction. All patients received coronal proton-density weightedorfat-suppressedT2-weightedimageswithaslice thickness of3–4mm. Theimages were reviewedusing the departmentalPACS(synedraview®,Synedra,Innsbruck, Aus-tria).Theanterolateralligamentcouldbeidentifiedin22ofthe 30patients(73.3%).Asshowninthefigureitcouldbefound dorsaltotheilitibialtractandvetraltothelateralcollateral ligament(Fig.1).Inmostpatientstheanterolateralligament could onlybeseenasaverythin ligamentousstructure,in somepatientsonlythepartinsertingatthelateralmeniscus couldbeidentified.Giventhesmallnumberofcasesno signif-icant differencesbetweenthedifferent scanners/sequences couldbeobserved.Otherorientationsofthesequences (sagit-tal/axial)werefoundtobeunreliableforthedepictionofthe anterolateralligament.Untilnowthe depictionofthis liga-menthasnotbeendiscussedintheradiologicalliterature.In anabstractoftheirworkClaesetal.4reportedabouta
rev bras ortop.2014;49(1):98–99
99
rupturedanteriorcruciateligament.Thedifferencemay be explainedbythefactthatthedepictionofligamentousinjury isfacilitatedbyjointeffusionandedematoussofttissues sep-aratingtheanatomicalstructures.Incontrast,ourapproach alsoincludedexamswithoutacutepathology,buttheydidnot reportthescannersorsequencesused.Inthesepatientsahigh frequencyoftornanterolateralligamentswasreported.
In conclusion, the recently reported anterolateral liga-mentcanbedepictedinthemajorityofpatientsundergoing standard MRIofthe knee. With a reductionofslice thick-ness or higher field strengths (3T) visibility will probably furtherincrease.Orthopedicsurgeonsandradiologistsshould beawareoftheimportanceofthisstructureandreportabout itwhenreviewingMRIscansoftheknee.
r
e
f
e
r
e
n
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e
s
1.HelitoCP,MiyahareHS,BonadioMB,TiricoLE,GobbiRG, DemangeMK,etal.Anatomicalstudyontheanterolateral ligamentoftheknee.RevBrasOrtop.2013;48(4):368–73. 2.ClaesS,VereeckeE,MaesM,VictorJ,VerdonkP,BellemansJ.
Anatomyoftheanterolateralligamentoftheknee.JAnat. 2013;223(4):321–8.
3.VincentJP,MagnussenRA,GezmezF,UguenA,JacobiM, WeppeF,etal.Theanterolateralligamentofthehumanknee: ananatomicandhistologicstudy.KneeSurgSportsTraumatol Arthrosc.2012;20(1):147–52.
4.ClaesSA,BartholomeeusssenS,VereeckeEE,VictorJM, VerdonkP,BellemansJ.Theanterolateralligamentoftheknee: anatomy,radiology,biomechanicsandclinicalimplications. Presentedatthe2013AAOSannualmeeting;2014.Available fromwww.abstractsonline.com
JohannesGossner
DepartamentodeRadiologiaClínica,HospitalGöttingen-Weende, Göttingen,Germany
E-mail:[email protected]
14November2013 20November2013
2255-4971/$–seefrontmatter
©2014SociedadeBrasileiradeOrtopediaeTraumatologia. PublishedbyElsevierEditoraLtda.Allrightsreserved.
