Double PCL sign

The double PCL sign is associated with bucket-handle tears of the medial meniscus that occur in the presence of an intact anterior cruciate ligament (ACL). A bucket-handle tear is a longitudinal tear of a meniscus that results in a displaced but attached meniscal fragment. The fragment may become displaced into the notch between the PCL and the medial tibial eminence in the midline, with the fragment orientated parallel to the PCL. The intact ACL serves as a barrier that prevents further lateral displacement of the meniscal fragment. The ACL is pivotal in the resulting alignment of the structures that are responsible for the depiction of the double PCL sign. Since ligaments and menisci demonstrate a hypointense signal with all pulse sequences, the displaced fragment will mimic a second PCL that is anterior and inferior to the true ligament, hence the name "double PCL sign" Discussion is from Radiology 2004;233:503-504. Marc A. Camacho, MD, MS. The Double Posterior Cruciate Ligament Sign.

Original case reported and submitted By Dr MGK Murthy, Dr Sumer Sethi of Teleradiology Providers