TY - JOUR
T1 - Diagnosis of Simultaneous Acute Ruptures of the Anterior Cruciate Ligament and Posterior Cruciate Ligament Using Point-of-Care Ultrasound in the Emergency Department
AU - Lee, Sun Hwa
AU - Yun, Seong Jong
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2018/3
Y1 - 2018/3
N2 - Background: Patients with acute anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) injuries from sport-related activities are frequently seen in the emergency department (ED). However, knee instability tests are known to show variable sensitivity and specificity. These tests would also have limited functionality in patients with severe pain and swelling in the knee. Case Report: A 19-year-old female judo player presented to the ED with severe left knee pain. She had abruptly twisted her left knee while she was shoulder-throwing her opponent. She complained of severe pain and refused physical examination of the knee injury; as a result, evaluation of knee instability could not be performed. However, a point-of-care ultrasound helped in making a prompt and accurate diagnosis of simultaneous, complete rupture and partial ruptures of the ACL and PCL, respectively. The ultrasound findings correlated well with the magnetic resonance imaging images in the assessment of the combined ACL-PCL ruptures. The patient underwent simultaneous arthroscopic ACL and PCL reconstruction with a hamstring tendon autograft and was discharged. Why Should an Emergency Physician Be Aware of This?: Point-of-care ultrasound imaging of the knee in trauma patients may be helpful for diagnosis of ACL and PCL injuries by augmenting findings of physical examinations in patients with severe pain and swelling in the knee. Ultimately, it may lead to more accurate diagnosis and treatment plans in knee trauma patients.
AB - Background: Patients with acute anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) injuries from sport-related activities are frequently seen in the emergency department (ED). However, knee instability tests are known to show variable sensitivity and specificity. These tests would also have limited functionality in patients with severe pain and swelling in the knee. Case Report: A 19-year-old female judo player presented to the ED with severe left knee pain. She had abruptly twisted her left knee while she was shoulder-throwing her opponent. She complained of severe pain and refused physical examination of the knee injury; as a result, evaluation of knee instability could not be performed. However, a point-of-care ultrasound helped in making a prompt and accurate diagnosis of simultaneous, complete rupture and partial ruptures of the ACL and PCL, respectively. The ultrasound findings correlated well with the magnetic resonance imaging images in the assessment of the combined ACL-PCL ruptures. The patient underwent simultaneous arthroscopic ACL and PCL reconstruction with a hamstring tendon autograft and was discharged. Why Should an Emergency Physician Be Aware of This?: Point-of-care ultrasound imaging of the knee in trauma patients may be helpful for diagnosis of ACL and PCL injuries by augmenting findings of physical examinations in patients with severe pain and swelling in the knee. Ultimately, it may lead to more accurate diagnosis and treatment plans in knee trauma patients.
KW - anterior cruciate ligament
KW - emergency department
KW - knee trauma
KW - point-of-care ultrasound
KW - posterior cruciate ligament
UR - http://www.scopus.com/inward/record.url?scp=85038391624&partnerID=8YFLogxK
U2 - 10.1016/j.jemermed.2017.11.014
DO - 10.1016/j.jemermed.2017.11.014
M3 - Article
C2 - 29269081
AN - SCOPUS:85038391624
SN - 0736-4679
VL - 54
SP - 335
EP - 338
JO - Journal of Emergency Medicine
JF - Journal of Emergency Medicine
IS - 3
ER -