Abstract
Purpose
Bone bruise represents an entity of occult bone lesions that can occur in the knee, causing knee pain and tenderness clinically. The aim of this study was to investigate the incidence and pattern of bone bruising seen in the anterior cruciate ligament (ACL) injury cohort, the non-ACL injury cohort, and between both cohorts.
Methods
We reviewed 710 knee magnetic resonance imagings performed over a 6-month period. Eighty-eight patients with prior history of a knee injury were identified. The mechanism of injury and other clinical findings was noted.
Results
Among these 88 patients, 58 patients had an associated ACL injury (31 had isolated ACL injuries; 27 had combined ACL and other ligamentous injuries). Among the 30 who had non-ACL injuries, 15 had either an MCL, LCL, or PCL injury. The remaining 15 patients had no associated ligament injury. With an ACL injury, the most common bone bruise sites are the lateral femur (74 %) and lateral tibia (64 %). Without an ACL injury, the pattern of bruising was more common in the lateral femur (69 %) and medial tibia (37 %).
Conclusion
Bone bruises are important as previous studies have shown that they can cause persistent knee pain. Our study has shown that there are differences in pattern of bone bruising in knee injuries with or without ACL injuries.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Mink JH, Deutsch AL (1989) Occult cartilage and bone injuries of the knee: detection, classification, and assessment with MR imaging. Radiology 170:823–829
Fowler PJ (1994) Bone injuries associated with anterior cruciate ligament disruption. Arthroscopy 10:453–460
Rosen MA, Jackson DW, Berger PE (1991) Occult osseous lesions documented by magnetic resonance imaging associated with anterior cruciate ligament ruptures. Arthroscopy 7:45–51
Speer KP, Spritzer CE, Bassett FHI (1992) Osseous injury associated with acute tears of the anterior cruciate ligament. Am J Sports Med 20:382–389
Spindler KP, Schils JP, Bergfeld JA (1993) Prospective study of osseous, articular, and meniscal lesions in recent anterior cruciate ligament tears by magnetic resonance imaging and arthroscopy. Am J Sports Med 21:551–557
Stein LN, Fischer DA, Fritts HM (1995) Occult osseous lesions associated with anterior cruciate ligament tears. Clin Orthop 313:187–193
Kaplan PA, Gehl RH, Dussault RG, Anderson MW, Diduch DR (1999) Bone contusions of the posterior lip of the medial tibial plateau (contrecoup injury) and associated internal derangements of the knee at MR imaging. Radiology 211:747–753
Rosen MA, Jackson DW, Berger PE (1991) Occult osseous lesions documented by magnetic resonance imaging associated with anterior cruciate ligament ruptures. Arthroscopy 7:45–51
Sanders TG, Medynski MA, Feller JF, Lawhorn KW. (2000) Bone contusion patterns of the knee at MR imaging: footprint of the mechanism of injury. Radiographics 20(spec no):S135–S151
Graf BK, Cook DA, De Smet AA, Keene JS (1993) “Bone bruises” on magnetic resonance imaging evaluation of anterior cruciate ligament injuries. Am J Sports Med 21:2220–2223
Miller MD, Osborne JR, Gordon WT, Hinkin DT, Brinker MR (1998) The natural history of bone bruises—a prospective study of magnetic resonance imaging-detected trabecular microfractures in patients with isolated medial collateral ligament injuries. Am J Sports Med 26(1):15–19
Mair SD, Schlegel TF, Gill TJ, Hawkins RJ, Steadman JR (2004) Incidence and location of bone bruises after acute posterior cruciate ligament injury. Am J Sports Med 32(7):1681–1687
Yoon KyoungHo, Yoo JaeHo, Kim Kang-Il (2011) Bone contusion and associated meniscal and medial collateral ligament injury in patients with anterior cruciate ligament rupture. J Bone Joint Surg 93:1510–1518
Lynch TCP, Crues JV, Morgan FW (1989) Bone abnormalities of the knee: prevalence and significance at MR imaging. Radiology 171:761–766
Costa-Paz M, Muscolo DL, Ayerza M, Makino A, Aponte-Tinao L (2001) Magnetic resonance imaging follow-up study of bone bruises associated with anterior cruciate ligament ruptures. Arthroscopy 17:445–449
Graf BK, Cook DA, De Smet AA, Keene JS (1993) “Bone bruises” on magnetic resonance imaging evaluation of anterior cruciate ligament injuries. Am J Sports Med 21:220–223
Murphy BJ, Smith RL, Uribe JW, Janecki CJ, Hechtman KS, Mangasarian RA (1992) Bone signal abnormalities in the posterolateral tibia and lateral femoral condyle in complete tears of the anterior cruciate ligament: a specific sign? Radiology 182:221–224
Bretlau T, Tuxøe J, Larsen L, Jørgensen U, Thomsen HS, Lausten GS (2002) Bone bruise in the acutely injured knee. Knee Surg Sports Traumatol Arthrosc 10:96–101
Viskontas DG, Giuffre BM, Duggal N, Graham D, Parker D, Coolican M (2008) Bone bruises associated with ACL rupture: correlation with injury mechanism. Am J Sports Med 36:927–933
Ross G, Chapman AW, Newberg AR, Scheller AD Jr (1997) Magnetic resonance imaging for the evaluation of acute posterolateral complex injuries of the knee. Am J Sports Med 25(4):444–448
Acknowledgments
The authors would like to thank Ms Wong Hung Chew, A/Prof Tai Bee Choo and Mr Benjamin Er for their efforts in performing the statistical analysis for this paper.
Conflict of interest
All the authors do not have any financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Chin, Y.C., Wijaya, R., Chong, L.R. et al. Bone bruise patterns in knee injuries: where are they found?. Eur J Orthop Surg Traumatol 24, 1481–1487 (2014). https://doi.org/10.1007/s00590-013-1319-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00590-013-1319-6