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MR imaging of anterior cruciate ligament tears: is there a gender gap?

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Abstract

Objective

Clinically, females receive anterior cruciate ligament (ACL) tears more commonly than males. We explored whether gender differences exist in MR imaging patterns of ACL tears.

Design and patients

At 1.5T, two observers evaluated MR examinations of 84 consecutive age-matched patients (42 males, 42 females, aged 16–39) with ACL tears, for mechanism of injury, extent and type of tear, the presence of secondary signs and associated osseous, meniscal and ligamentous injuries.

Results

The most common mechanism of injury for both females and males was the pivot shift mechanism (67 and 60%, respectively). Females were more commonly imaged in the acute stage of tear than males (98 and 67%, respectively, p=0.001) and more commonly possessed the typical posterolateral tibial bone contusion pattern (88 and 62%, respectively, p=0.0131). Males exhibited a deeper femoral notch sign (2.7 and 2.0 mm, p=0.007) and medial meniscal, lateral collateral ligament and posterior cruciate ligament injuries more commonly than females (48 and 24%, p=0.009, 30 and 7%, p=0.035, 17 and 0%, p=0.035). There was no significant difference between genders for the presence of other secondary signs and contusion patterns, associated lateral meniscal tears, presence of O'Donoghue's triad or associated medial collateral ligament injuries.

Conclusion

Gender differences in MR imaging patterns of ACL tears exist: females are more commonly imaged in the acute stage and more commonly possess posterolateral tibial bone contusions; males have a more severe presentation than females, associated with more severe lateral femoral condyle and soft tissue injuries.

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Authors and Affiliations

  1. The Russell H. Morgan Department of Radiology and Radiological Science, John Hopkins Medical Institutions, 601 North Wolfe Street, Baltimore, MD, 21287-0750, USA

    Laura M. Fayad

  2. Department of Radiology, Thomas Jefferson University Hospital, Gibbon Building Suite 3390, 111 South 11th St., Philadelphia, PA, 19107-5098, USA

    J. Antoni Parellada, Laurence Parker & Mark E. Schweitzer

Authors
  1. Laura M. Fayad
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  2. J. Antoni Parellada
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  3. Laurence Parker
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  4. Mark E. Schweitzer
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Correspondence to Laura M. Fayad.

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Fayad, L.M., Parellada, J.A., Parker, L. et al. MR imaging of anterior cruciate ligament tears: is there a gender gap?. Skeletal Radiol 32, 639–646 (2003). https://doi.org/10.1007/s00256-003-0694-1

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  • DOI: https://doi.org/10.1007/s00256-003-0694-1

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