Contusion Research Articles

Magnetic resonance imaging does not reliably detect Kaplan fiber injury in the setting of anterior cruciate ligament tear.

There has been a continued effort to better understand the role Kaplan fiber injury plays in persistent instability following ACL tears. However, the prevalence of these injuries remains poorly understood. Therefore, the purpose of this study was to define the prevalence of Kaplan fiber injury in the setting of complete anterior cruciate ligament tear using a commonly used grading system for assessing ligament injuries. The inter-rater reliability of this commonly used grading system and the relationship between Kaplan fiber injury and injury to other structures commonly found in conjunction with ACL tears was also evaluated. All isolated, complete anterior cruciate ligament tears confirmed on magnetic resonance imaging within 90days of injury between 2014 and 2020 at a single institution were included for analysis. Each scan was read by two, fellowship-trained musculoskeletal radiologists. Kaplan fiber injury was evaluated using a previously described grading scheme. Kappa, [Formula: see text], of inter-rater agreement was determined for all magnetic resonance image scans. Kruskal Wallis test was performed to assess for associations between Kaplan fiber injury and magnet strength (1.5T vs. 3.0T), patient gender, the presence of medial and/or lateral meniscal tears, and/or posterolateral tibial bone bruise. Between 2014 and 2020, 131 patients (94 males, 37 females) with a complete anterior cruciate ligament tear were included in the final analysis. The mean age of the cohort was 27.8 ± 6.8years. Kaplan fiber injuries were identified in 51 of 131 (38.9%, CI 31.0-47.5%) scans with complete anterior cruciate ligament injuries (Grade 1: 28, Grade 2: 18, and Grade 3: 5). Inter-rater agreement for Kaplan fiber injury was fair ([Formula: see text] with 43 (32.8%) scans requiring third reviewer adjudication. There were no significant associations between Kaplan fiber injury and gender, magnet strength, meniscal tears, or posterolateral tibial bone bruise. The prevalence of Kaplan fiber injuries was comparable to previously described rates; however, the classification system used to report Kaplan fiber injury was associated with low inter-rater reliability. The presence of Kaplan fiber injury was not associated with other injuries commonly observed in conjunction with ACL tear. The previously proposed Kaplan fiber injury classification system is not reproducible nor is it likely to aid surgeons in distinguishing higher grades of rotatory knee instability. Level IV.

KM.

![KM and her son sitting on a beach while on vacation in Hawaii in 2019][1]</img> KM and her son on vacation in Hawaii in 2019. Photo by AM, KM’s husband My symptoms started in my early 20s. I would go often to my family doctor with different vague complaints — leg pains, easy bruising,

Rattlesnake envenomation in 2 Visayan warty pigs.

Rattlesnake envenomation is an important cause of morbidity and mortality in humans and animals in the southwestern United States and elsewhere. Two Visayan warty pigs (Sus cebifrons) from a regional zoo were submitted for autopsy after being found dead close to a southern Pacific rattlesnake (Crotalus helleri) in their enclosure. Both pigs had severe regionally extensive cutaneous, subcutaneous, and muscle hemorrhage and edema with myonecrosis. Additionally, both pigs had lesions consistent with puncture wounds within the oral cavity, and one pig had a similar wound on a forelimb. The history, and gross and histologic findings, were consistent with envenomation by rattlesnake bite. There are few documented cases of snakebite envenomation in pigs, and it had been suggested that pigs may have some degree of resistance to envenomation. Our results indicate that warty pigs are susceptible to the action of rattlesnake venom.

Severe bicompartmental bone bruise is associated with rotatory instability in anterior cruciate ligament injury

PurposeThe presence and severity of bone bruise is more and more investigated in the non-contact anterior cruciate ligament (ACL) injury context. Recent studies have advocated a correlation between bone bruise and preoperative knee laxity. The aim of the present study was to investigate the correlation between bone bruise and preoperative rotatory knee laxity.MethodsTwenty-nine patients (29.1 ± 9.8 years) with MRI images at a maximum of 3 months after ACL injury (1.6 ± 0.8 months) were included. The bone bruise severity was evaluated according to the International Cartilage Repair Society (ICRS) scale for lateral femoral condyle, lateral tibial plateau, medial femoral condyle, and medial tibial plateau. The intraoperative rotational knee laxity was evaluated through a surgical navigation system in terms of internal–external rotation at 30° and 90° of knee flexion (IE30, IE90) and internal–external rotation and acceleration during pivot-shift test (PS IE, PS ACC). The KOOS score was also collected. The association between ICRS grade of bone bruise and rotational laxity or KOOS was investigated.ResultsSignificant correlation (p < 0.05) was found between the bone bruise severity on the medial tibial plateau and rotational laxity (IE90, PS IE, and PS ACC) and between the severity of bone bruise on femoral lateral condyle and KOOS-Symptoms sub-score. The presence of bone bruise on the medial tibial plateau was significantly associated with a lateral femoral notch sign > 2 mm (very strong odds ratio). No kinematical differences were found between none-to-deep and extensive-generalized lateral bone bruise, while higher IE30 and IE90 were found in extensive-generalized bicompartmental bone bruise than isolated extensive-generalized lateral bone bruise.ConclusionA severe bicompartmental bone bruise was related to higher rotatory instability in the intraoperative evaluation of ACL deficient knees. The severity of edema on the medial tibial plateau was directly correlated with higher intraoperative pivot shift, and the size of edema on the lateral femoral condyle was associated with lower preoperative clinical scores.Level of evidenceLevel II.

APPLICATION OF MAGNETIC RESONANCE IMAGING IN EVALUATING ANKLE MOTION INJURY

ABSTRACT Introduction Discuss the application of magnetic resonance imaging in evaluating ankle motion injury. Objective Verify the influencing factors of magnetic resource imaging (MRI) diagnosis based on the linear regression algorithm model. Methods The experimental group was diagnosed by MRI, while the control group was diagnosed by plain X-ray. After that, the mathematical model of the linear regression algorithm was constructed. Results It could be concluded that the MRI detection rate was 85.71%, and the X-ray plain film detection rate was 77.14%. The linear regression model analysis showed that the P-value of cartilage injury, tendon fracture, bone contusion, and soft tissue swelling was greater than 0.05. Conclusions MRI has more advantages in the application of ankle joint diagnosis. And ligament injury and joint effusion are the influencing factors of MRI diagnosis, which can highly indicate the authenticity of the injury in the ankle joint. Level of evidence II; Therapeutic studies - investigation of treatment results.

An Ulcerating Perineal Rash in an 8-month-old Girl.

An Ulcerating Perineal Rash in an 8-month-old Girl.

Klebsiella pneumoniae causing mass mortality in juvenile Nile tilapia in Brazil: Isolation, characterization, pathogenicity and phylogenetic relationship with other environmental and pathogenic strains from livestock and human sources

Klebsiella pneumoniae is a critical-priority human pathogen, considered a key trafficker of drug resistance genes from environmental to clinically important bacteria. Although current evidence suggests its potential role as aquatic pathogen, there are few reports of infections in cultured fish, and its pathogenicity to Nile tilapia remains unknown. Here we report the mass mortality in cultured Nile tilapia caused by a natural infection of K. pneumoniae, along with the bacteria isolation, phenotype, pathogenesis in Nile tilapia, and phylogenetic relationships with strains isolated from environmental, livestock, and human samples from different locations. High morbidity and mass mortality (~90 thousand fish within 4 days) of juvenile Nile tilapia (32 ± 6.0 g) occurred in July 2018 in a commercial fish farm located in Brazil. The main clinical signs during the outbreak included lethargy, anorexia, subcutaneous haemorrhages, urogenital bleeding, and ascites. The bacteria (n = 7) were isolated and identified as K. pneumoniae by morphological evaluation, biochemical tests, nucleotide sequencing and phylogenetic analysis of a partial sequence of the highly conserved 16S rRNA gene. All clinical isolates were catalase-positive, and the hypermucoviscous phenotype associated with hypervirulent K. pneumoniae was not detected. The pathogenicity for Nile tilapia and phylogenetic relationships with other K. pneumoniae strains were determined by experimental infection and phylogenetic reconstruction by maximum likelihood and Bayesian inference methods, respectively. All clinical isolates were included in the clade of K. pneumoniae, and most of them were differentiated from both environmental and pathogenic strains from different locations, including Brazil. Experimentally infected Nile tilapia exhibited similar clinical signs and severe histological changes in the liver, spleen, intestine, kidney, and gills as fish that were naturally infected, fulfilling Koch's postulates and demonstrating the virulence of the recovered strain. The LD10, 50, 90, and 99 were established in 2.1 × 103, 1.2 × 107, 1 × 1010, and 8.7 × 1013 colony-forming units (CFU)/mL, respectively. This is the first description of K. pneumoniae natural infection in Nile tilapia along with its pathogenesis, denoting a hidden risk for both animal and human health.

Effects of Primary Mast Cell Disease on Hemostasis and Erythropoiesis.

Mast cell disease is an epigenetically and genetically determined disease entity with very diverse clinical manifestations in potentially every system and tissue due to inap pro priate release of variable subsets of mast cell mediators together with accumulation of either morphologically normal or altered mast cells. Easy bruising, excessive bleeding, and aberrancies of erythropoiesis can frequently be observed in patients with mast cell disease. A thorough history, including a family history, will guide the appropriate work-up, and laboratory evaluations may provide clues to diagnosis. In recent years, our understanding of the involvement of coagulation and anticoagulant pathways, the fibrinolytic system, and erythropoiesis in the pathophysiology of mast cell disease has increased considerably. This review summarizes current knowledge of the impact of the disturbed hemostatic and erythropoietic balance in patients with mast cell disease and describes options of treatment.

Risk Factors of Neurological Complications in Severe Fever Patients with Thrombolytic Syndrome: A Single-Center Retrospective Study in China.

BackgroundSevere fever with thrombocytopenia syndrome is a serious insect-borne infectious disease caused by the Huaiyangshanbanyang virus. We conducted a retrospective study to identify risk factors for neurological complications caused by the virus.Material/MethodsWe included 121 patients who had severe fever with thrombocytopenia syndrome and were admitted to our hospital from 2013 to 2020. Patients’ laboratory test results and clinical data were collected. Univariate and multivariate regression were used for statistical analysis.ResultsPatients with neurological complications had higher mortality rates and longer hospital stays and disease duration than did patients without neurological complications. The neurological symptoms with the highest incidence rates were involuntary tremors (tongue and mandible), cognitive disorder, and limb tremors. Patients with neurological complications had a higher incidence of abnormal heart rhythms. Subcutaneous bleeding, pulmonary rales, percentage of neutrophils, increased lactate dehydrogenase and C-reactive protein levels, and decreased chloride ion concentration were closely related to the occurrence of neurological complications. The significant decrease in chloride ion concentration within 1 to 5 days of disease onset may be a risk factor for predicting the occurrence of neurological complications in patients with severe fever with thrombocytopenia syndrome.ConclusionsEarly monitoring of subcutaneous bleeding, pulmonary rales, electrocardiogram changes, and biochemical indicators in patients with severe fever with thrombocytopenia syndrome can predict the occurrence of neurological complications.

A Rare Pediatric Case Report With Review of Literature for the Diagnosis of Acute Megakaryoblastic Leukemia (FAB M7)

Acute megakaryoblastic leukemia (AMKL) is a subtype of acute myeloid leukemia (AML) accounting for 3%–10% of primary AML in childhood. Clinical manifestations of AML patients can include low grade of fever, diarrhea, easy bruising, failure to growth, and life-threatening clinical manifestations. Laboratory tests are very crucial to make a definitive diagnosis and treatment. We report here an uncommon case of AMKL in a 12-month-old boy who presented with general paleness and fatigue. Based on blood film investigation, bone marrow examination report, and immunophenotyping, he was diagnosed as a case of AMKL without Down syndrome.

Prevalence of sarcopenia after remission of hypercortisolism and its impact on HRQoL.

Cushing's syndrome (CS) is associated with skeletal muscle structural and functional impairment which may persist long-term despite surgical removal of the source of cortisol excess. Prevalence of sarcopenia and its impact on Health-Related-Quality of Life (HRQoL) in 'cured' CS is not known. There is a need to identify easy biomarkers to help the clinicians recognise patients at elevated risk of suffering sustained muscle function. We studied 36 women with CS in remission, and 36 controls matched for age, body mass index, menopausal status, and level of physical activity. We analysed the skeletal muscle mass using dual-energy X-ray absorptiometry, muscle fat fraction using two-point Dixon magnetic resonance imaging and muscle performance and strength using the following tests: hand grip strength, gait speed, timed up and go and 30-s chair stand. We assessed HRQoL with the following questionnaires: SarQoL, CushingQoL, SF-36. We calculated the sarcopenia index (SI; serum creatinine/serum cystatin C × 100). Prevalence of sarcopenia, according to the European Working Group on Sarcopenia in Older People (EWGSOP), was greater in CS as compared with controls (19% vs. 3%; p < .05). Patients with sarcopenia had a lower SarQoL score than those without sarcopenia (61 ± 17 vs. 75 ± 14; p < .05), and scored worse on the items pain, easy bruising and worries on physical appearance (p < .05 for all comparisons) of the CushingQoL questionnaire. Patients with sarcopenia had poorer physical functioning on SF-36 than those without sarcopenia (60 ± 23 vs. 85 ± 15; p < .01). SI was lower in patients with sarcopenia than those without (71 ± 3 vs. 77 ± 2; p = .032), and was associated with intramuscular fatty infiltration, worse performance on the 30-s chair stand test, slower gait speed, and worse muscle weakness-related HRQoL, as measured using the SarQoL questionnaire (p < .05). The optimised cut-off value for the SI ratio to diagnose sarcopenia was 72, which yielded a sensitivity of 73% and a specificity of 90%. Sarcopenia is common in patients with CS in long-term remission, and associated with impaired quality of life. The SI is a potential biomarker allowing clinicians to identify patients at high risk of muscle dysfunction.

Lateral femoral notch sign and posterolateral tibial plateau fractures and their associated injuries in the setting of an anterior cruciate ligament rupture

IntroductionACL injury is one of the most common injuries of the knee joint in sports. As accompanying osseous injuries of the ACL rupture a femoral impression the so-called lateral femoral notch sign and a posterolateral fracture of the tibial plateau are described. However, frequency, concomitant ligament injuries and when and how to treat these combined injuries are not clear. There is still a lack of understanding with which ligamentous concomitant injuries besides the anterior cruciate ligament injury these bony injuries are associated.Materials and methodsOne hundred fifteen MRI scans with proven anterior cruciate ligament rupture performed at our center were retrospectively evaluated for the presence of a meniscus, collateral ligament injury, a femoral impression, or a posterolateral impression fracture. Femoral impressions were described according to their local appearance and posterolateral tibial plateau fractures were described using the classification of Menzdorf et al.ResultsIn 29 cases a significant impression in the lateral femoral condyle was detected. There was a significantly increased number of lateral meniscal (41.4% vs. 18.6% p = 0.023) and medial ligament (41.4% vs. 22.1%; p = 0.040) injuries in the group with a lateral femoral notch sign. 104 patients showed a posterolateral bone bruise or fracture of the tibial plateau. Seven of these required an intervention according to Menzdorf et al. In the group of anterior cruciate ligament injuries with posterolateral tibial plateau fracture significantly more lateral meniscus injuries were seen (p = 0.039).ConclusionIn the preoperative planning of ACL rupture accompanied with a positive femoral notch sign, attention should be paid to possible medial collateral ligament and lateral meniscus injuries. As these are more likely to occur together. A posterolateral impression fracture of the tibial plateau is associated with an increased likelihood of the presence of a lateral meniscal injury. This must be considered in surgical therapy and planning and may be the indication for necessary early surgical treatment.

Acute Lymphoblastic Leukemia Mimicking Bilateral Wilms Tumour: A Radiologic Review

ALL with renal involvement may mimic Wilms's tumor due to overlap of their clinical and radiological findings. These include malaise, anemia, easy bruising, uncontrolled clotting, pedal edema, ballot able kidneys, deranged renal function tests, signs of immunosuppression and common imaging features of enlarged kidneys bilaterally in both diseases.

Characterizing the effects of in utero valproic acid exposure on murine fetoplacental development

IntroductionValproic acid (VPA) is an effective anti-epileptic drug clinically used to treat seizures, bipolar disorders and neuropathic pain in women of reproductive age. Current approval of VPA for psychiatric conditions and migraine has increased the number of VPA exposed pregnancies. VPA crosses the placental barrier and induces birth defects in about 10% of exposed pregnancies. In addition, VPA exposure results in neurodevelopmental disorders in children without any overt birth defects. The current study was designed to investigate the effects of in utero VPA exposure on fetoplacental growth in a mouse model. MethodsPregnant CD-1 dams were exposed to a single teratogenic dose of 400 mg/kg VPA or saline via subcutaneous injection on gestational day (GD) 9 and fetuses were harvested on GD 13, 15, 17 and 19, respectively. Resorptions, gross malformations, fetal weight, fetal head weight, fetal crown-rump length, fetal head transverse and anteroposterior diameters, placental weight and placental diameter were noted. ResultsVPA exposure led to multiple external deformities including exencephaly, open eye defect, subcutaneous hemorrhage and underdevelopment of tail. All fetoplacental growth parameters fetal weight, fetal head weight, fetal crown-rump length, placental weight and placental diameter were significantly reduced in VPA-exposed fetuses with and without congenital malformations such as exencephaly, compared to control fetuses. DiscussionIn conclusion, the effects of in utero VPA exposure on fetal and placental growth persisted throughout pregnancy and our results suggest that the effects of VPA on placental growth may play a role in VPA-induced toxicity.

Platelet Aggregation Assays Do Not Reliably Diagnose Platelet Delta Granule Storage Pool Deficiency.

BackgroundPatients with platelet dysfunction disorders present with a variety of mucocutaneous bleeding symptoms including easy bruising, frequent epistaxis, bleeding gums upon tooth brushing and for women, heavy menstrual bleeding. Available laboratory assays to evaluate platelet function include the platelet function analyzer (PFA) and in larger centers with coagulation laboratories, light transmission platelet aggregometry (LTA) analyses. Both assays are known to have a number of limitations, especially in the diagnosis of platelet delta granule storage pool deficiency (δ-SPD). δ-SPD is an underdiagnosed condition caused by decreased numbers of platelet dense granules (DGs) and is best diagnosed by electron microscopy (EM). Patients with platelet δ-SPD have a decreased response to low levels of the agonist adenosine diphosphate (ADP) in the second wave of light transmittance with LTA or decreased ADP secretion by fluorescence lumiaggregometry. There are few reports that have evaluated patients with δ-SPD and their respective LTA results. One report published in 1987 described normal LTA assays in 23% of patients with δ-SPD; a more recent report described LTA as having the sensitivity to detect only about 52% of patients with δ-SPD. The purpose of our study was intended to review the LTA and EM results of patients suspected of having a platelet function disorder at our institution for comparison with previously published studies.MethodsOur study included 344 patients who had been evaluated by both LTA and whole mount EM. Aggregometry utilized five agonists: ADP, epinephrine, collagen, arachidonic acid, and ristocetin. DGs were enumerated in 100 whole-mounted platelets to determine a mean number of dense granules per platelet (DGs/PL).ResultsSeventy-seven percent of our patients were found to have δ-SPD (264/344); 68% (179/264) of these subjects had an abnormal platelet LTA. Thirty-two percent (85/264) of our patients had normal LTA results but were found to have δ-SPD with a mean of 2.54 ± 0.15 DG/PL (normal = 4 - 6 DG/PL).ConclusionThese data confirm previous reports suggesting the utilization of LTA alone in patients with histories of unexplained bleeding may miss the diagnosis of platelet δ-SPD. It is, therefore, prudent to assess platelet DG number by EM, especially if platelet LTA assessment is normal.

Clinical phenocopies of albinism

To present a series of patients diagnosed with oculocutaneous albinism (OCA) based on clinical presentation who were later proven to have a different diagnosis. The medical records of patients seen at the Pediatric Inherited Eye Disease Clinic of the University of Iowa from 1980 to 2018 who were eventually discovered to have an incorrect diagnosis of OCA were reviewed retrospectively. Eight pediatric patients presenting with clinical features suggestive of OCA which changed to a different diagnosis over time were identified. Presenting clinical features included fair pigmentation of the skin and adnexa (8/8), congenital nystagmus (6/8), decreased visual acuity (8/8), iris transillumination defects (8/8), and foveal hypoplasia (7/8). Of the 8 patients, 4 manifested progressive, preschool-age-onset myopia. Other associated clinical features included hearing loss (3), seizures (1), abnormal chest x-ray (1) and easy bruising (2). During follow-up, additional clinical features and genetic testing proved that they have different clinical entities, namely, Knobloch syndrome, Jeune syndrome, Donnai-Barrow syndrome, Waardenburg syndrome, Aniridia syndrome, Stickler syndrome, and Hermansky-Pudlak syndrome, one of the syndromic types of OCA. Clinical features used to diagnose OCA also occur in other disorders. For a definitive diagnosis of OCA, ancillary/genetic testing must be performed. Clinical features not typically found in association with albinism, such as hearing loss, or early onset, or progressive myopia, may indicate the need for more extensive investigation.

Palliative local treatment of bone metastases by 125I seed brachytherapy under DynaCT guidance: single-center experience.

We aimed to evaluate the clinical benefit of 125I seed brachytherapy under DynaCT guidance for palliative local treatment of bone metastases. From December 2014 to September 2017, 82 patients with painful bone metastases, who experienced treatment failure using standard strategies or rejected treatment were enrolled in this retrospective study. All patients underwent 125I seed brachytherapy under DynaCT guidance. Technical success, visual analogue scale (VAS), numerical rating scale (NRS), verbal rating scale (VRS), Karnofsky performance status (KPS) and complications were analyzed. The success rate of 125I seed implantation was 100%. The VAS and NRS scores for the most severe pain were 7.0 (5.0-9.0) and 8.0 (6.0-9.0) before brachytherapy. The pain scores assessed every 2 hours gradually decreased within 12 hours (p < 0.001). A comparison of KPS scores showed that patients had significantly better quality of life on weeks 1, 4, and 8 than on week 0 (p < 0.001). The associated complications were mild subcutaneous hemorrhage 25.6% (21/82), fever 7.3% (6/82), minor displacement of radioactive seeds 5.0% (4/82), pathologic fracture 2.4% (2/82), and local skin reaction 2.4% (2/82). After symptomatic treatment, all complications were relieved. Minor displacement of radioactive seeds did not cause damage to adjacent tissues. No serious life-threatening complications occurred in the study group. DynaCT-guided 125I seed implantation is a safe and effective method for palliation of painful bone metastases from cancer after failure or rejection of conventional treatments.

Whiplash injury of the cervical spine

Whiplash injury is acommon trauma of the cervical spine which usually occurs during motor vehicle accidents, especially involving rear-end collisions. The trauma typically results from asudden biphasic movement of the head and cervical spine (reclination followed by inclination), which may cause an injury of bony, muscular and ligamentous elements. The most common symptoms of whiplash injury are pain, stiffness and tenderness of the neck, which occur with alatency of several hours and may become chronic in some patients. The imaging studies rarely demonstrate morphological changes associated with trauma and there are also no specific imaging findings in whiplash injuries. Plain films and computed tomography are used in acute trauma workup to exclude bony injuries. Magnetic resonance imaging (MRI) may demonstrate occult fractures, bone contusions as well as muscular and ligamentous posttraumatic lesions. The whiplash injuries are classified clinically according to Quebec Task Force-Grading, depending on the symptom severity.

Clinical Implications of Bone Bruise Patterns Accompanying Anterior Cruciate Ligament Tears.

Anterior cruciate ligament (ACL) tears are common injuries; they are often associated with concomitant injuries to other structures in the knee, including bone bruises. While there is limited evidence that bone bruises are associated with slightly worse clinical outcomes, the implications of bone bruises for the articular cartilage and the risk of developing osteoarthritis (OA) in the knee are less clear. Recent studies suggest that the bone bruise pattern may be helpful in predicting the presence of meniscal ramp lesions. A literature review was performed in EMBASE using the keyword search phrase (acl OR (anterior AND cruciate AND ligament)) AND ((bone AND bruise) OR (bone AND contusion) OR (bone AND marrow AND edema) OR (bone AND marrow AND lesion) OR (subchondral AND edema)). Clinical review. Level 4. The literature search returned 93 articles of which 25 were ultimately included in this review. Most studies identified a high prevalence of bone bruises in the setting of acute ACL injury. Individual studies have found relationships between bone bruise volume and functional outcomes; however, these results were not supported by systematic review. Similarly, the literature has contradictory findings on the relationship between bone bruises and the progression of OA after ACL reconstruction. Investigations into concomitant injury found anterolateral ligament and meniscal ramp lesions to be associated with bone bruise presence on magnetic resonance imaging. Despite the ample literature identifying the prevalence of bone bruises in association with ACL injury, there is little evidence to correlate bone bruises to functional outcomes or progression of OA. Bone bruises may best be used as a marker for concomitant injury such as medial meniscal ramp lesions that are not always well visualized on magnetic resonance imaging. Further research is required to establish the longitudinal effects of bone bruises on ACL tear recovery. 2.

Deep Learning-Based Magnetic Resonance Imaging Image Features for Diagnosis of Anterior Cruciate Ligament Injury.

To study and explore the adoption value of magnetic resonance imaging (MRI) in the diagnosis of anterior cruciate ligament (ACL) injuries, a multimodal feature fusion model based on deep learning was proposed for MRI diagnosis. After the related performance of the proposed algorithm was evaluated, it was utilized in the diagnosis of knee joint injuries. Thirty patients with knee joint injuries who came to our hospital for treatment were selected, and all patients were diagnosed with MRI based on deep learning multimodal feature fusion model (MRI group) and arthroscopy (arthroscopy group). The results showed that deep learning-based MRI sagittal plane detection had a great advantage and a high accuracy of 96.28% in the prediction task of ACL tearing. The sensitivity, specificity, and accuracy of MRI in the diagnosis of ACL injury was 96.78%, 90.62%, and 92.17%, respectively, and there was no considerable difference in contrast to the results obtained through arthroscopy (P > 0.05). The positive rate of acute ACL patients with bone contusion and medial collateral ligament injury was substantially superior to that of chronic injury. Moreover, the incidence of chronic injury ACL injury with meniscus tear and cartilage injury was notably higher than that of acute injury, with remarkable differences (P < 0.05). In summary, MRI images based on deep learning improved the sensitivity, specificity, and accuracy of ACL injury diagnosis and can accurately determined the type of ACL injury. In addition, it can provide reference information for clinical treatment plan selection and surgery and can be applied and promoted in clinical diagnosis.