MENISCOTIBIAL LIGAMENT TEAR DEEP MCL MRI KNEE

• The dMCL lies deep to the sMCL.
   
• It has 2 components.
  1. Menisco Femoral &,
  2. Menisco Tibial.

• Both attach to the body of the medial meniscus

• The Meniscotibial ligament extends from medial meniscus to the medial tibial condyle.

• Look for 2 things,
  1. Increased signal of the ligament.
     • Normally the menisco-tibial ligament is low signal.
  2. Ill definition & thickening of the ligament.

• The menisco-tibial component is stronger than the menisco-femoral and is less commonly torn.

In this case the menisco-tibial ligament is hyper-intense, thickened and ill defined (Pink arrows). All features of a torn menisco-tibial ligament.

You can also see that similar changes are present in the proximal sMCL which is also torn (Blue arrow).

• Assess on coronal scans the menisco-tibial and menisco-femoral ligaments.
   
• Start by assessing the sMCL.
   
• Once you have looked at the sMCL look immediately deep to it to find the deep MCL components.