Eline De Smet

The Anterolateral Ligament of the Knee: What the Radiologist Needs to Know

The anterolateral ligament (ALL) was recently identified as a distinct component of the anterolateral capsule of the human knee joint with consistent origin and insertion sites. Biomechanical studies revealed that the current association between the pivot shift and an injured anterior cruciate ligament (ACL) should be loosened and that the rotational component of the pivot shift is significantly affected by the ALL. This may change the clinical approach toward ACL-injured patients presenting with anterolateral rotatory instability (ALRI), the most common instability pattern after ACL rupture. Radiologists should be aware of the importance of the ALL to ACL injuries. They should not overlook pathology of the anterolateral knee structures, including the ALL, when reviewing MR images of the ACL-deficient knee. In this article, the current knowledge regarding the anatomy, biomechanical function, and imaging appearance of the ALL of the knee is discussed with emphasis on the clinical implications of these findings.

Diffusion tensor imaging of the anterior cruciate ligament graft

A great need exists for objective biomarkers to assess graft healing following ACL reconstruction to guide the time of return to sports. The purpose of this study was to evaluate the feasibility and reliability of diffusion tensor imaging (DTI) to delineate the anterior cruciate ligament (ACL) graft and to investigate its diffusion properties using a clinical 3T scanner.

Imaging of the Postoperative Anterior Cruciate Ligament: Emphasis on New Surgical and Imaging Methods

The aim of anterior cruciate ligament (ACL) reconstruction is to restore normal function of the knee, but unfortunately abnormal kinematics and a predisposition to knee osteoarthritis occur in a significant percentage of patients. So there is an ongoing need to improve treatment options and long-term outcome of patients with a ruptured ACL. With the recent advancements in the field of ACL tissue engineering, the focus of treatment for ACL injuries is changing from resection and reconstruction toward repair and regeneration. Several new ACL repair methods were recently introduced as an alternative to traditional ACL reconstructive procedures. Radiologists must become familiar with these new surgical methods to interpret their appearance correctly on postoperative imaging studies. This article provides an overview of the latest advancements in ACL surgical methods and discusses the role of imaging to assess the postoperative ACL including both standard and advanced imaging methods.

Traumatic myelopathy: current concepts in imaging.

Traumatic myelopathy is a frequent complication after spinal trauma. The prognosis is often very poor, and the condition has important socioeconomic consequences. Knowledge of the epidemiology and imaging features is mandatory to ensure correct diagnosis and timely intervention. Imaging studies play an increasing role in the diagnosis and follow-up of this condition. Computed tomography remains the first-line investigation whenever spinal cord injury is suspected. It may indicate the presence of spinal cord lesions by visualizing vertebral lesions, but it cannot assess the spinal cord itself. Magnetic resonance imaging (MRI) can depict possible spinal cord edema, hemorrhage, or transection, and it is essential in diagnosing and predicting the outcome of spinal cord injury. Follow-up should also be performed with MRI to evaluate long-term intramedullary changes. Diffusion-weighted imaging and diffusion tensor imaging are promising new techniques that allow very early detection of spinal cord injury by measuring the diffusion within the spinal cord, thereby providing information on white matter integrity. However, technical limitations of these new techniques prompt further investigation to improve specificity.

Diagnostic Algorithm of Soft Tissue Tumors

This chapter provides a diagnostic algorithm as well as essential key points for the initial imaging diagnosis of soft tissue tumors (STTs). However, the diversity and rarity of soft tissue tumors demand for a tailored approach of each lesion, dependent of tumor characteristics.