Diagnosis | Cruciate ligament overstretched

Diagnosis

The diagnosis of a cruciate ligament overstretch is usually made by an orthopedist or trauma surgeon. He evaluates the injury by means of a medical history and a physical examination. During this examination, the physician examines the knee and pays attention to knee swelling, pain during stress and movement, and loss of function.

By means of various tests he can assess the different structures of the knee, he will probably describe the gait pattern and the leg axes, the stability in the knee joint and the surrounding muscles. An important part of the examination after an injury or accident is always the control of blood circulation and sensitivity. As a rule, the physical examination is sufficient to confirm the suspicion of overstretching, but in rare cases, further instrumental procedures may be necessary to rule out any differential diagnoses, such as a torn cruciate ligament or meniscus. The physician can use ultrasound, MRI or CT for this purpose.

How does a torn cruciate ligament differ from an overstretched one?

When the cruciate ligament is overstretched, the ligament is stretched far beyond its natural extent, but without tearing. In the case of cruciate ligament rupture, this limit has been exceeded. An important difference between these injuries is that with a torn cruciate ligament, stability is lost in the knee joint.

Often, patients are unable to stand or walk with their knee. However, this instability may be absent if the thigh muscles are pronounced, so that a rupture can also be overlooked. The instability is often increased and noticed especially when climbing stairs. In contrast to an overstretched cruciate ligament, a tear causes damage to the supplying blood vessels, which results in bleeding into the knee joint and can lead to swelling and joint effusion (haemarthros). This is an important distinguishing feature from overstretching the ligament.Other symptoms, such as pain or swelling, can occur both with a torn cruciate ligament and with overstretching.

MRI of the knee

Magnetic resonance imaging (MRI) is a sectional view of the body without radiation exposure. It is mainly used for imaging soft tissues, such as ligaments or muscles. For this reason, an MRI is a very popular means of further diagnosis in the case of a knee injury.

In particular, it is used to search for possible concomitant injuries and to distinguish overstretching from a cruciate ligament rupture, which can be recognized as a clear continuity interruption in the MRI. However, a sole assessment of the knee with an MRI is not recommended, since false negative findings may also occur. It must therefore always be assessed in conjunction with the symptoms and the physical examination. On the other hand, the MRI can also find injuries that were not suspected during the physical examination.