Ultimate guide to MR anatomy of the Posterolateral Corner in the Knee

How to assess the posterolatearal corner on MRI. In this video, I show you the anatomy of all posterolateral corner structures (PCL) that you need to know and how to simplify the assessment of knee MRI for posterolateral corner injuries. It does not have to be complicated.
The three important structure you need to assess are the:
1. lateral collateral ligament (LCL)
2. biceps femoris tendon
3. popliteus tendon
Smaller structures you can asses are:
4. poplitefibular ligament
5. meniscopopliteal fascicles
6. fabellofibular ligament
7. arcuate ligament
If you want to go deeper, check out this two selected scientific articles:
pubs.rsna.org/...
www.ncbi.nlm.n...
#kneeMRI #PLC #MRI
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[@BogdanNMarincu]

This was super helpful and will definitely help me improve my reports. Thank you!

[@DrChristophAgten]

Cool. Thx

[@EvaFarkasova-p1p]

Very useful video. In one MSK Ultrasound course someone wanted to teach us how to find arcuate ligament. How weird!

[@89sachinkumar]

Have been struggling with search for this arcuate ligament since a long time. We have this checklist style reporting and I hate filling the posterolateral corner section of the report. Great video, Dr. Agten

[@DrChristophAgten]

That is good to read. Any other structures you are struggling with? Just fishing for some ideas

[@gulnaragayeva170]

Doctor Please more posts about shoulder impingement ...

[@neuroradnerd]

Nice lecture!!!

[@DrChristophAgten]

Glad it was helpful!

[@baranitharan6381]

Thanks for the great lecture Dr. Agten. Can you please help me differentiate OPL and arcuate ligament .

[@mainakde1744]

Excellent ♥️

[@DrChristophAgten]

Thank you! Cheers!

[@utkarshkabra5304]

Really nice videos with examples!:)

[@DrChristophAgten]

Thanks! 😃

[@hasaneminkaya8440]

I always found it a daunting task to evaluate the posterolateral corner structures particularly after I had learned that posterolateral corner injury is considered as a surgical emergency by some orthopedic surgeons. Your video made me feel more comfortable. Thanks.

[@DrChristophAgten]

Cool

[@VoldoDance]

Great as usual. Do you have a video on MCL? also seems confusing the classification system (superficial, middle, deep vs superficial and deep) and different attachments. I think it can make a nice, informative yet quick video!

[@DrChristophAgten]

I'll consider it

[@DrChristophAgten]

I'll add it to my list

[@VoldoDance]

@@DrChristophAgten great, looking forwards to!!

[@premsivalingarajah1561]

i laughed at your comment 'so stupid'🤣. Totally agree with u it is. But as a surgeon we only want to know FCL or some call it LCL, popliteus and PFL. These are structures that can be reconstructed. PFL is needed yea.

[@oguzar8727]

Great video..thank you :)

[@DrChristophAgten]

Thx

[@burtd24]

Arcuate ligaments: An enigma to all radiologists... but of questionable importance. Leave it to beaver.

[@luckyolwaz]

The topic made incredibly simple! Thanks a ton!

[@immane75]

When you are confused about finding a ligament like the arcuate ligament , they confuse you more by other structures like finding the geniculates vessels ......... the potero latéral corner was nightmare for me ...........;

[@DrChristophAgten]

interestingly enough at ECR in the Level III knee session, the arcuate ligamet was predominantely featured again, without giving clear anatomy------- still confused :D

[@immane75]

@@DrChristophAgten LOL, the guy from NY , confuse me more with the RAMP lesion and tutti quanti ; found the wrist for sport injury very well donne though .

[@TheSaber2010]

Thanks a lot.. great disambiguation

[@DrChristophAgten]

Glad you liked it

[@vipanmagotra9972]

SIR WHAT IS STRENGTH OF MACHINE WHISE IMAGES ARE DISPLAYED HERE

[@aihammahdi8698]

I liked when U said a stupid, it is really stupid

[@zohebmulla3670]

Colon or large intestine ulcers can be seen in ct scan?

[@qigong1001]

KZbin is filled with endless amounts of videos about IT band syndrome with physiologist and doctors diagnosing it without an MRI. And you will often see the KZbin thumbnail with a model pointing to the PLC area with pain on their face with title “how to fix your IT band “. I personally believe this is a severely misdiagnosed problem. I believe most problems are really PLC problems as IT band is not really a distinct structure. Even the new research which tries to debunk “it band” will talk about the fat pad under the IT band which is interesting, but not backed up with any evidence. Whilst ignoring all these other structural elements. I’m personally dealing with some sort of PLC issue probably from running and plan to get an MRI soon. Wondering your thoughts on this. Maybe make a video?

[@DrChristophAgten]

Iliotibial band friction syndrome is seen on MRI with the edema between the IZ Band and lateral femoral condyle. I have a video about runners knee already. And IT band is a distinct anatomic structure. In don't think IT band as an anatomic structure needs to be debunked. Sometimes edema at that location can be seen in asymptomatic people on MRI if it's subtle. It's always good to get MRI for confirmation of a suspected pathology as we often see alter active reasons for knee pain and not the expected diagnosis as clinical assessment in many knee things seems not very specific

[@qigong1001]

@@DrChristophAgten yes what I mean by debunking “IT band”, I mean “IT band syndrome”, just to be clear. However, the IT band as source of injury is really questionable. Looking at cadaver dissections IT band ii looks too continuous, and I’ve heard anatomist just call it the “thick strip” of the connective tissue. So it’s not as distinct as one would think like they show in cartoon anatomical drawings . Yes, it’s a real thing, but part of something else much broader. Anyway, you see people massaging the TFL or the upper insertion areas to “loosen up”the IT band or exercises to strengthen the muscles that contribute to the IT band (glute m. , tfl). But theres research that shows no noteworthy evidence that strengthening these muscles or foam rolling helps in anyway . That’s the majority of these KZbin videos!To me this is medical misinformation. I understand you can see the swelling in the MRI in that area, but there is no reason to call it “it band syndrome”. And I believe the literature confirms what I am saying. Many reputable papers will state that there is limited evidence for the cause of pain in that area. I’m not gonna list sources here because anytime I cite sources, my comment gets deleted (weird thing with the algorithm). It’s just a catchall term for pain in that area. The causes could be numerous. As your videos expertly show, there’s a level of complexity in that area that does not justify a simple dx ITBS . The pros need to come to term with this in order to advance understanding. Anyway, I’ll leave you alone now, just my two cents..lols! Let’s just call it BSsyndrome.

[@rashasalah-eldein2314]

nice ppt thank you

[@weichianong5986]

I loved this video as it made it a lot easier for me to understand my own MRI. I was wondering, in the event of a high grade lateral collateral ligament tear, but the remaining supporting lateral ligamentous structures are normal, is it common practice just to reconstruct the LCL, or do a complete anatomical reconstruction of the posterolateral corner including the politeus tendon and the politeal fibula ligament?

[@DrChristophAgten]

That is more a question for a knee surgeon.

[@dimpisinha2182]

Honestly I still feel difficulty in interpretation of arcuate ligament in my 10 years of radiology practice

[@DrChristophAgten]

Yes. Because it doesn't really exists and everybody things if something different. 😉

[@Suhkyungjin]

Thanks a lot. You are the best!

[@hathijabeevi2155]

Hello sir ,My mother 52 years old. The doctor took an MRI scan and said that the swelling of the membrane on the lower side of the spune was affecting the blood flow in the veins of the right leg. The doctor said that the solution can be treatef with laser treatment. Is there ant other way?

[@mozammelhaque7200]

Particular identification of arcuate ligaments is not clear.

[@DrChristophAgten]

because there is no such thing or everybody thinks it is something different.

[@أحمدعبدالرزاق-ك3ز]

Many Thanks.

[@ImTheiWarrior]

Hello, I wonder if you are open for sending you dicom files to investigate it. I'm suffering from issues in the posteror pain which isn't showing anything - HOWEVER, there dial test is considered positive (with 5 dagrees). It's been a year and half since my injury and none can indentify it (I have downloaded the MRI but it's clearly isn't so much meaningful for me). Cheers, Mor

[@DrChristophAgten]

I offer second opinions through www.aristra.com

[@jonesalex565]

Brilliant. I've never seen an arcuate ligament in my life.

[@DrChristophAgten]

some say not to use the term at all, so you probably did not miss anything at all. different paper call different structures the arcuate ligament.

[@muratgulcek7528]

👏

[@furkanturkoglu3219]

Great job. Ty four your efforts

[@DrChristophAgten]

Thanks