Journal of Computer Assisted Tomography. 39(1):57–63, JANUARY/FEBRUARY 2015
DOI: 10.1097/RCT.0000000000000160
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PMID: 25319603
Issn Print: 0363-8715
Publication Date: January/February 2015
The Anteromedial Tibial Rim Sign: An Indicator of Patellotibial Impaction in Acute Anterior Cruciate Ligament Tears
Robert Wissman;Eric England;Kaushal Mehta;Michael Burch;Ariyan Javadi;Keith Newton;
+ Author Information
From the Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH.
Abstract
We have encountered unexplained anteromedial tibial rim edema in acute anterior cruciate ligament (ACL) tears. Our goal was to determine the incidence, internal derangements, and mechanism of injury in patients with anteromedial tibial rim edema (rim sign).A retrospective review of ACL tears diagnosed by magnetic resonance imaging over 7 years was performed. Patients were dichotomized into those with and without a rim sign.There were 132 acute ACL tears. Individuals with a rim sign (31, 23%) had more contusions, fractures, ligament tears (P < 0.001), posterolateral corner injuries (P = 0.001), and posterior horn lateral meniscus tears (P = 0.042) than those without. Five individuals demonstrated edema in the inferior patella, consistent with patellotibial impaction.The rim sign is common in ACL tears, indicating greater internal derangement. The rim sign represents patellotibial impaction with edema rarely present in the patella.
