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H K Genant

Publications and source records attributed to H K Genant.

At least 253 records · Page 14Linked to original sources
PubMed1995

[CT and MRI in elastofibroma. A rare, benign soft tissue tumor].

Elastofibroma is a rare, benign soft-tissue tumor that occurs along the chest wall in the periscapular region. We identified five patients with a surgical diagnosis of elastofibroma who had had CT and/or MR scans. CT and MR imaging were compared to histologic findings in two patients. CT was available in three patients and demonstrated periscapular soft-tissue tumor with an attenuation similar to that of adjacent muscle. In one patient, the tumors appeared homogeneous. In two patients, the tumor showed strands of low density similar to that of adjacent subcutaneous fat on CT. On MR imaging, all five tumors showed predominantly low-signal intensity on both T1 and T2-weighted images. The tumors contained focal areas with high-signal intensity on T1-weighted scans that showed intermediate to high-signal intensity with T2-weighting. The areas of low-signal intensity on both T1 and T2-weighted images corresponded histologically to fibroelastic tissue. The areas of high signal intensity on T1-weighting and intermediate to high-signal intensity on T2-weighting reflected focal areas of fat within the tumor. Although CT and MR imaging findings are not specific, the presence of a soft-tissue tumor along the chest wall in a periscapular location that shows predominantly low intensity on all sequences reflecting fibrous tissue with interspersed focal areas of fatty tissue is highly suggestive of elastofibroma.

Aged↗
PubMed1995

The association of radiographic changes of osteoarthritis of the hand and hip in elderly women.

OBJECTIVE: To examine the association of radiographic features of hand and hip osteoarthritis (OA) in elderly women. METHODS: Hand and hip radiographs were read for changes of OA from a sample of 1422 women aged 65 and above who were participants in the Study of Osteoporotic Fractures. Definite hip OA required the presence of 2 or more of the following: moderate or large osteophytes, moderate or severe joint space narrowing, subchondral sclerosis, cysts, and femoral head deformity. Definite hand OA required moderate or large osteophytes at 2 or more of the following 6 sites: 2nd and 3rd distal and proximal interphalangeal joints and 1st interphalangeal and carpometacarpal joints. Data were analyzed using multiple logistic regression adjusting for age, weight at age 50, and current height. RESULTS: Overall, 147 (10.4%) women had radiographic changes of definite hip OA and 68 (4.8%) had severe hip OA; 56 had bilateral and 87 had unilateral disease. Definite hand OA was present in 732 (51.4%) women. Hand OA was significantly associated with definite hip OA [odds ratio (OR) = 3.25, 95% confidence intervals (CI) 2.19, 4.84], and severe hip OA (OR = 3.23, 95% CI 1.82, 5.73). Hand OA was significantly associated with bilateral hip OA (OR = 3.54, 95% CI 1.87, 6.73) as well as unilateral hip OA (OR = 3.06, 95% CI 1.84, 5.08). CONCLUSION: These data are consistent with the inclusion of radiographically defined hip OA in the construct of generalized OA, particularly in elderly women.

Aged↗
PubMed1994

Monitoring bone resorption in early postmenopausal women by an immunoassay for cross-linked collagen peptides in urine.

A new immunoassay using an ELISA approach for measuring urinary excretion of cross-linked N-telopeptides of type 1 collagen was evaluated as a specific measure of bone resorption. The assay was applied to 65 early postmenopausal women who participated in a placebo-controlled trial of the aminobisphosphonate, alendronate sodium. Eight blood and urine samples were collected over a 9 month interval. Baseline cross-linked peptide excretion varied from 26 to 216 pmol BCE (bone collagen/mumol Cr. Within-subject variability (CV) for cross-linked peptide excretion was 20.2% over the 9 months in placebo-treated subjects, substantially less than that observed for other biochemical markers of bone resorption: 45, 53, and 63% for fasting urinary calcium and hydroxyproline and 24 h urinary lysylpyridinoline (HPLC assay), respectively. Baseline cross-linked peptide excretion correlated significantly (p < 0.001) with baseline total urine lysylpyridinoline and serum osteocalcin, but not with the other biochemical markers. Initial peptide excretion also correlated inversely with lumbar spine bone mineral density at entry (r = -0.26, p < 0.05). Treatment for 6 weeks with alendronate produced a dose-dependent suppression of cross-linked peptide excretion (0 +/- 8, 29 +/- 6, 56 +/- 5, and 64 +/- 3% for 0, 5, 20, and 40 mg, respectively, p < 0.01 versus placebo for treatment effect), with a return toward pretreatment values during follow-up. Measurement of the urinary cross-linked N-telopeptides of type I collagen by this new ELISA approach appears promising as a simple and reliable method to assess overall bone resorption.(ABSTRACT TRUNCATED AT 250 WORDS)

Alendronate↗
PubMed1994

Prediction of hip fractures from pelvic radiographs: the study of osteoporotic fractures. The Study of Osteoporotic Fractures Research Group.

To determine whether simple measurements made on conventional radiographs of the hip could predict hip fractures, we obtained pelvic radiographs on 9704 white women age 65 or older. We analyze the radiographs of all 162 women who subsequently suffered a hip fracture and 162 randomly selected women who did not. Adjusting for age, four measurements independently predicted hip fractures: reduced thickness of the femoral shaft cortex (odds ratio 1.7 per standard deviation; 95% confidence interval 1.2, 2.3) and of the femoral neck cortex (1.4 per standard deviation; 1.0, 1.9), reduction in an index of tensile trabeculae (2.0 per unit; 1.4, 2.9), and wider trochanteric region (1.4 per standard deviation; 1.0, 2.0). The combination of these four measurements predicted hip fracture at least as strongly as did measurement of bone density of the femoral neck (areas of the receiver-operating characteristic curve = 0.81 and 0.80, respectively). We conclude that simple measurements made on pelvic radiographs predict hip fractures as well as bone density of the hip.

Absorptiometry, Photon↗
PubMed1994

Dual x-ray absorptiometry forearm software: accuracy and intermachine relationship.

An ash study was performed to analyze the accuracy of forearm measurements at the one-third site of three dual x-ray absorptiometry (DXA) systems using 20 cadavers. A Hologic QDR-2000, a Hologic QDR-1000/W, and a Lunar DPX-L system were used. The correlations between ash weight and DXA BMC were excellent for the three instruments (r > 0.97, p < 0.001), with accuracy errors < 5.2%. To perform a forearm cross-calibration of bone mineral content (BMC) and density (BMD) between the scanners, 10 healthy volunteers were additionally scanned at the distal one-third radius. The correlations among the DXA machines were excellent (r > 0.95); the absolute BMC and BMD values were significantly different between the two Hologics and the Lunar machine. The slope and intercept of both the BMC and BMD between the two Hologic systems were close to unity. In conclusion, the DXA forearm software packages provide accurate methods for assessing bone mineral content and density. The conversion of data among different manufacturers should be performed by careful cross-calibration measurements.

Absorptiometry, Photon↗
PubMed1994

Does estimating volumetric bone density of the femoral neck improve the prediction of hip fracture? A prospective study. Study of Osteoporotic Fractures Research Group.

Standard projectional bone density of the femoral neck (BMD), defined as bone mineral content divided by the projected area of the neck, predicts hip fractures but may not accurately estimate the true volumetric bone density of the femoral neck. To determine whether an estimate of the volumetric bone density of the neck, "bone mineral apparent density" (BMAD), would be a better predictor of hip fracture, we analyzed dual x-ray absorptiometry scans obtained prospectively from 7963 older white women, of whom 83 suffered a hip fracture during follow-up. Both BMD and BMAD were stronger predictors than bone mineral content (BMC) of the femoral neck. However, BMD and BMAD had very similar predictive values for hip fracture: each standard deviation decrease in either BMD or BMAD of the femoral neck increased the age-adjusted risk of hip fracture 2.6- to 2.7-fold. We conclude that BMD and BMAD of the femoral neck have a similarly strong predictive value for hip fracture.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗
PubMed1994

Universal standardization for dual x-ray absorptiometry: patient and phantom cross-calibration results.

The comparison of patient data among different dual x-ray absorptiometry (DXA) scanners is complicated because no universally accepted cross-calibration procedure or standard currently exists. This study was performed under the auspices of the International DXA Standardization Committee to establish appropriate cross-calibration parameters. Posteroanterior (PA) lumbar spine measurements of 100 women, ages 20-80 years (mean 52.6 +/- 16, range of BMD = 0.4-1.6 g/cm2) were obtained on a Norland XR26 Mark II, a Lunar DPX-L, and a Hologic QDR 2000 densitometer using standard procedures (pencil beam mode for all three scanners). Area, BMC, and BMD results from the different scanners were compared for all patients. In addition, the European spine phantom (ESP) and the European spine phantom prototype (ESP prototype), as well as standard phantoms from all three manufacturers, were evaluated on the three systems. To achieve universal scanner calibration, we used the intercept and slope of the patient's correlations and the value of the middle vertebra of the ESP as a reference point in a series of standardization formulas, and we have expressed the results as sBMD (mg/cm2). The correlations of the patients' spinal BMD values were excellent for each of the three scanner pairs. The average absolute difference in patient spinal BMD values (L2-4) between Hologic and Norland was 0.012 g/cm2 (1.3%); it was 0.113 g/cm2 (11.7%) between Hologic and Lunar and 0.118 g/cm2 (12.2%) between Norland and Lunar. The phantoms' regression lines approximated those of the patient regression lines, and the phantoms with only one measurement point were very close to the patients' regression lines. After applying the standardization formulas, the average absolute differences for the 100 patients were 28 mg/cm2 (2.7%) for Hologic/Norland, 23 mg/cm2 (2.2%) for Hologic/Lunar, and 29 mg/cm2 (2.8%) for Norland/Lunar. Average BMD results for the patients before correction were 0.972 mg/cm2 for Hologic, 1.100 g/cm2 for Lunar, and 0.969 g/cm2 for Norland. After correction, sBMD results for patients were 1045 mg/cm2 for Hologic, 1047 mg/cm2 for Lunar, and 1043 mg/cm2 for Norland. The standardization approach as performed in our study provided compatibility of DXA results obtained on different scanners.

Absorptiometry, Photon↗
PubMed1994

Phantom studies simulating the impact of trabecular structure on marrow relaxation time, T2'.

Phantom studies were conducted to investigate the impact of trabecular structure on the T2' signal measured by MRI. For a separation of density from structural effects, several phantoms were built. They consisted of parallel polyethylene strings arranged in a variety of different patterns to simulate a) a constant uniform trabecular distribution with increasing trabecular thickness and b) different structures with identical overall trabecular density. An asymmetric spin echo sequence was used to determine the apparent relaxation time T2'. Changes in T2' are induced by susceptibility differences between the polyethylene strings simulating trabeculae and Gd-DTPA doped saline simulating bone marrow. The results showed an increasing T2' decay rate with a) decreasing spacing while the string density was constant and b) with increasing string density while the string arrangement was constant. The results demonstrate that the T2' signal is affected not only by density but also by spatial distribution. However, the results also indicate that a separation of the two effects is not possible from a T2' measurement alone, but that e.g., a matching CT slice that would provide purely density information is additionally needed. Theoretical simulations confirmed these results.

Bone Marrow↗
PubMed1994

Interobserver variation in the detection of osteopenia by radiography and comparison with dual X-ray absorptiometry of the lumbar spine.

In 100 patients (20 male, 80 female) radiographs of the lumbar spine were obtained in both planes, anteroposterior and lateral. Nine readers independently and without specific criteria or training assessed the radiographs for presence of osteopenia in the form of a binary decision. A posteranterior dual x-ray absorptiometry (PA DXA) measurement of the lumbar spine was performed in all patients using the Hologic QDR 1000 bone densitometer. A bone mineral density (BMD) of 0.83 g/cm2 (T-score about 2 SD and 2.5 SD lower than BMD in normal young female and male subjects respectively) was used as a threshold for the diagnosis of osteopenia. Complete agreement amongst the 9 readers was achieved in 43 patients. In 26 more patients at least 8 readers agreed. kappa-coefficients for interobserver variation ranged from 0.458 to 0.691 for reader pairs. For agreement between the observer ratings and the DXA results, kappa-coefficients ranging between 0.347 and 0.555 were found. The vast majority of readers agreed in the diagnosis of osteopenia in cases where the BMD was less than 0.73 g/cm2. Where the BMD was between 0.73 and 1.03 g/cm2 a substantial disagreement was found between reader evaluation and DXA measurement, and also amongst the readers. We conclude from our results that osteopenia can reliably be detected from lumbar spine radiographs by all readers only after a substantial amount of BMD is lost. On the other hand, a diagnosis based solely on PA DXA measurement of the spine may also lack accuracy, due to a substantial influence of degenerative changes of the lumbar spine and aortic calcification.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗
PubMed1994

Three quantitative ultrasound parameters reflect bone structure.

We investigated whether quantitative ultrasound (QUS) parameters are associated with bone structure. In an in vitro study on 20 cubes of trabecular bone, we measured broadband ultrasound attenuation (BUA) and two newly defined parameters--ultrasound velocity through bone (UVB) and ultrasound attenuation in bone (UAB). Bone mineral density (BMD) was measured by dual X-ray absorptiometry (DXA) and bone structure was assessed by microcomputed tomography (microCT) with approximately 80 microns spatial resolution. We found all three QUS parameters to be significantly associated with bone structure independently of BMD. UVB was largely influenced by trabecular separation, UAB by connectivity, and BUA by a combination of both. For a one standard deviation (SD) increase in UVB, a decrease in trabecular separation of 1.2 SD was required compared with a 1.4 SD increase in BMD for the same effect. A 1.0 SD increase in UAB required a reduction in connectivity of 1.4 SD. Multivariate models of QUS versus BMD combined with bone structure parameters showed squared correlation coefficients of r2 = 0.70-0.85 for UVB, r2 = 0.27-0.56 for UAB, and r2 = 0.30-0.68 for BUA compared with r2 = 0.18-0.58 for UVB, r2 < 0.26 for UAB and r2 < 0.13 for BUA for models including BMD alone. QUS thus reflects bone structure, and a combined analysis of QUS and BMD will allow for a more comprehensive assessment of skeletal status than either method alone.

Absorptiometry, Photon↗
PubMed1994

Bone mineral density predicts non-spine fractures in very elderly women. Study of Osteoporotic Fractures Research Group.

To determine the ability of bone density to predict fractures in very elderly women, we examined the association of bone density with non-spine, hip, wrist and humerus fractures in 8699 Caucasian women aged 65-79 years and 1005 women aged 80 years and older who were participants in the prospective Study of Osteoporotic Fractures. Follow-up averaged 4.9 (+/- 1.0) years after baseline measurement of appendicular bone density (single-photon absorptiometry; Osteon-Osteo Analyzer) and 2.9 (+/- 0.6) years after measurement of hip and anteroposterior lumbar spine bone density (dual-energy X-ray absorptiometry; Hologic QDR 1000) at a later examination. In general, measurements of bone density in the oldest women retained their predictive value for fractures. Among women aged 80 and over a 1 standard deviation decrease in bone density of the distal radius was associated with an increased risk of non-spine (relative risk: 1.6; 95% confidence interval: 1.3, 1.8), wrist (1.7; 1.2, 2.4) and humerus fracture (2.9; 1.8, 4.7), while a 1 standard deviation decrease in femoral neck bone density was associated with an increased risk of non-spine (1.9; 1.6, 2.4), humerus (2.4; 1.2, 4.7) and hip fracture (2.1; 1.4; 3.2). However, only trochanteric but not femoral neck fractures were associated with low bone density in these oldest women. The excess risk of fracture in women with below-median bone density was greater in those aged 80 years and over compared with the younger women: 38.4 v 20.4 per 1000 woman-years for non-spine fracture and 12.2 v 3.2 per 1000 woman-years for hip fracture.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗
PubMed1994

Comparison of a semiquantitative and a quantitative method for assessing vertebral fractures in osteoporosis.

There is no agreed definition for the assessment of vertebral fractures and deformities in patients with osteoporosis. Radiographs of 66 patients randomized for therapy with etidronate or placebo were analyzed at baseline and during follow-up (60/120/150 weeks) independently using two procedures. The first method of spinal deformity index (SDIG) and vertebral deformity score (VDSG) is based on a semiquantitative visual reading of each vertebra between T4 and L4. The second method of spine deformity index (SDIM) and vertebral deformity index (VDIM) is based on vertebral height measurements of T4 through L5 and each measurement from T5 to L5 (anterior, middle and posterior height) is related to T4 and compared with the respective T4-related normal range. There was good agreement between the mean vertebral deformation from T5 to L4 graded by VDSG and VDIM, with correlation coefficients between R = 0.52 (p < 0.0001) and R = 0.9 (p < 0.0001) respectively. Spinal deformation at baseline as measured by SDIM and SDIG was correlated with R = 0.76 (p < 0.0001). For diagnosing a vertebra as fractured or not, VDIM reached a sensitivity of 82% and a specificity of 85% using VDSG as a standard, and on the other hand VDSG reached a sensitivity of 78% and a specificity of 88% in relation to VDIM. The changes in spinal deformation from week 0 to 150 were correlated with R = 0.58 (p < 0.0002) between SDIM and SDIG. To detect vertebral fracture progression the sensitivity of VDIM was 74% and the specificity 86%, when changes in VDSG were used as a standard.(ABSTRACT TRUNCATED AT 250 WORDS)

Etidronic Acid↗
PubMed1994

MR imaging of the arthritic knee: improved discrimination of cartilage, synovium, and effusion with pulsed saturation transfer and fat-suppressed T1-weighted sequences.

PURPOSE: To assess the applicability of three-dimensional (3D) magnetic resonance (MR) imaging with pulsed saturation transfer (ST) or fat saturation in depicting articular structures in arthritic knees. MATERIALS AND METHODS: Eleven patients underwent MR imaging with T1-weighted spin-echo (SE); unenhanced and contrast material-enhanced T2*-weighted 3D gradient-echo with and without on-resonance pulsed ST; and T1-weighted, fat-presaturated 3D gradient-echo techniques. Images with ST were subtracted from those without ST. RESULTS: Both fat-suppressed imaging and ST-subtraction (STS) techniques generated a high contrast-to-noise ratio among cartilage, synovium, effusion, bone, and adipose tissue. Both techniques depicted hypertrophic synovial tissue on unenhanced images; contrast material was necessary to differentiate between synovium and cartilage on STS images. CONCLUSION: 3D MR imaging with fat-suppressed or STS techniques provides good discrimination among articular structures in arthritic knees. Fat-suppressed imaging is faster than STS imaging and offers better contrast between cartilage and synovium. These techniques may improve monitoring of arthritic disease progression and therapeutic response.

Arthritis, Rheumatoid↗
PubMed1994

Quantification of articular cartilage in the knee with pulsed saturation transfer subtraction and fat-suppressed MR imaging: optimization and validation.

PURPOSE: To assess the reproducibility and accuracy of volumetric quantifications of articular cartilage in the knee determined with three-dimensional (3D) magnetic resonance (MR) imaging combined with pulsed saturation transfer subtraction (STS) or T1-weighted fat suppression (FS) imaging. MATERIALS AND METHODS: Eight osteoarthritic knees were imaged repeatedly with optimized STS and FS sequences. Cartilage volumes were determined from 3D reconstructions of FS and STS images and by means of water displacement of surgically retrieved tissue. RESULTS: Mean over- or underestimation of cartilage volume at STS and FS imaging was 0.40 mL +/- 0.11 (standard deviation) (8.2%) and 0.31 mL +/- 0.08 (5.9%), respectively. Intraobserver reproducibility error was 0.20-0.65 mL (3.6%-6.4%) for STS and 0.21-0.58 mL (4.2%-6.4%) for FS imaging. Interobserver error was less than 0.62 mL and 7.8%. CONCLUSION: Three-dimensional data analysis of MR images acquired with STS or FS allows accurate and reproducible volumetric quantification of articular cartilage in the knee.

Aged↗
PubMed1994

MR arthrographic depiction of tears of the rotator cuff: benefit of abduction and external rotation of the arm.

PURPOSE: To show the effectiveness of positioning the arm in abduction and external rotation (ABER) during magnetic resonance (MR) arthrography for depiction of tears of the rotator cuff. MATERIALS AND METHODS: Five throwing athletes with shoulder pain were prospectively imaged with standard MR imaging, MR arthrography, and ABER MR arthrography. The status of the rotator cuff was recorded; arthroscopic correlation was obtained. RESULTS: One partial tear of the distal infraspinatus tendon was detected with ABER MR arthrography only. One full-thickness tear was detected with both MR arthrography and ABER MR arthrography, but the component of the tear that extended into the infraspinatus tendon was depicted with ABER MR arthrography only. One partial tear was detected with both MR arthrography and ABER MR arthrography; no additional information was provided by either technique alone. CONCLUSION: The ABER position may be useful in detection and characterization of tears of the rotator cuff, especially partial tears of the undersurface. This information would be useful in selection of patients for conservative therapy, arthroscopy, or arthrotomy.

Adult↗
PubMed1994

Radiographic absorptiometry for bone mineral measurement of the phalanges: precision and accuracy study.

PURPOSE: To evaluate the accuracy and precision of a radiographic absorptiometry (RA) method for assessment of bone mineral of the middle phalanges. MATERIALS AND METHODS: Nineteen cadaveric hands were radiographed with an aluminum wedge, once at 50 kVp and 400 mA and once at 60 kVp and 300 mA. Bone mineral content (BMC) and bone mineral density (BMD) of the second to fourth middle phalanges, expressed in arbitrary units (BMC-AU and BMD-AU), were analyzed and averaged in each hand. RESULTS: The precision error of this method was 1.0% for BMC-AU and 0.6% for BMD-AU. A 2.0%-2.4% reduction in BMD-AU seen on radiographs obtained through ethanol thicknesses of 5 and 6 mm compared with that seen on controls was statistically significant (P < .01). The correlation between BMC-AU and forearm BMC determined with dual x-ray absorptiometry was good (r = .887), and that between BMC-AU and ash weight in the phalanges was excellent (r = .983). CONCLUSION: The RA method is precise and accurate for bone mineral assessment of the peripheral appendicular skeleton.

Absorptiometry, Photon↗
PubMed1994

MR diagnosis of complete tears of the anterior cruciate ligament of the knee: importance of anterior subluxation of the tibia.

OBJECTIVE: The primary role of the anterior cruciate ligament is to resist anterior subluxation of the tibia. When the ligament is torn, the tibia is free to sublux anteriorly when the leg is pulled forward. In addition to visualizing the anterior cruciate ligament directly, MR imaging can show joint alignment. The purpose of this study was to test the efficacy of MR images of anterior subluxation of the tibia for diagnosing complete tears of the anterior cruciate ligament. MATERIALS AND METHODS: We evaluated the records of 120 consecutive patients who underwent MR imaging of the knee and subsequently had arthroscopy. Arthroscopy showed a complete tear of the anterior cruciate ligament in 21 patients, a partial tear in eight patients, and an intact anterior cruciate ligament in 91 patients. Two radiologists together reviewed the MR images, and interpretation of anterior cruciate ligament integrity was reached by consensus. The anterior cruciate ligament was categorized as intact, completely torn, or partially torn on the basis of conventional MR imaging criteria. The degree of anterior subluxation of the tibia was measured on a separate occasion in random order by a radiologist who used a sagittal section through the middle of the lateral femoral condyle. On the selected image, two vertical lines parallel to the left and right margins of the image frame were drawn tangent to the posterior cortical margins of the lateral femoral and tibial condyles. Anterior subluxation of the tibia was determined by the distance in millimeters between these two lines and measured with calipers by using the 5-cm scale on the images. Measurements were considered reliable only to one half of the smallest increment of this scale (i.e., 5 mm). Accordingly, tibial subluxation (x) was measured in 5-mm increments, with x < or = 0 mm designated grade 0, 0 mm < x < or = 5 mm designated grade 1, 5 mm < x < or = 10 mm designated grade 2, and so forth. RESULTS: Conventional MR imaging criteria had 90% sensitivity and 94% specificity for diagnosing complete tears of the anterior cruciate ligament. According to the receiver-operating-characteristic (ROC) curve, anterior subluxation of the tibia greater than 5 mm (grade 2 or greater) was considered to be the optimal threshold (sensitivity, 86%; specificity, 99%) for diagnosing complete tears of the anterior cruciate ligament. Notably, none of the six false-positive diagnoses of complete tears by conventional criteria (three partial tears and three intact ligaments at arthroscopy) were misdiagnosed when tibial subluxation was used as the diagnostic criterion. Subluxation greater than 5 mm can be falsely negative with chronic tears of the anterior cruciate ligament (n = 2) or when a displaced bucket-handle tear of the lateral meniscus blocks anterior subluxation of the tibia (n = 1). CONCLUSION: An anterior tibial subluxation greater than 5 mm (grade 2 or greater) is a simple objective measurement that serves as a helpful adjunctive sign in the diagnosis of complete tears of the anterior cruciate ligament. This sign also offers improved discrimination of complete from partial tears of the anterior cruciate ligament.

Adult↗