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. 2018 Jul 27;6(7):2325967118786960.
doi: 10.1177/2325967118786960. eCollection 2018 Jul.

Bone Bruises in Children and Adolescents Not Associated With Ligament Ruptures [corrected]

Jorge E Gómez  1 , Daren D Molina  1 , Shaylon D Rettig  2 , J Herman Kan  1
Affiliations

Bone Bruises in Children and Adolescents Not Associated With Ligament Ruptures [corrected]

Jorge E Gómez et al. Orthop J Sports Med. .

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] Orthop J Sports Med. 2019 Jan 31;7(1):2325967119831698. doi: 10.1177/2325967119831698. eCollection 2019 Jan. Orthop J Sports Med. 2019. PMID: 30783605 Free PMC article.

Abstract

Background: Clinical characteristics of uncomplicated bone bruises (ie, not associated with a ligament rupture, meniscal tear, or fracture of the knee) in young athletes have scarcely been reported.

Purpose: To identify mechanisms of injury, characterize bone bruise patterns, and identify clinical factors relating to recovery in young patients suffering uncomplicated bone bruises about the knee.

Study design: Case series; Level of evidence, 4.

Methods: A review of clinical records and magnetic resonance imaging (MRI) findings of patients seen at a single institution was completed.

Results: We identified 62 children and teenagers (mean age, 13.9 years; range, 8-18 years) who had a total of 101 bone bruises on MRI. The injuries occurred during a variety of organized and recreational sporting activities, the most common being football, basketball, and soccer. The majority (61.4%) of bone bruises occurred as a result of noncontact mechanisms. Patients reported a mean pain scale score of 6.3 of 10 (range, 2-10) on presentation. Frequent clinical findings included non-joint-line tenderness (64.5%), limited range of motion (58.1%), joint-line tenderness (54.8%), and positive meniscal signs (50.0%). The majority of bone bruises (61.4%) were located medially, and the most common bone bruise type was subcortical (58.4%), followed by medullary/reticular (35.6%) and articular impaction (5.9%). The only factor related to time to recovery was mechanism of injury; patients reporting a noncontact mechanism required significantly more time to recover than those reporting a contact mechanism (mean, 99.7 ± 74.8 vs 65.7 ± 38.8 days, respectively; F = 3.753, P = .049).

Conclusion: In this case series of 62 pediatric patients with non-anterior cruciate ligament (ACL) bone bruises, the majority occurred in the medial compartment, suggesting that these bone bruises result from a mechanism distinct from the pivot-shift mechanism, classically thought to cause ACL injuries.

Keywords: MRI; adolescent; bone bruise; child; knee; pediatric sports medicine.

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Conflict of interest statement

The authors declared that they have no conflicts of interest in the authorship and publication of this contribution.

Figures

Figure 1.
Figure 1.
Proton density–weighted fat-saturated coronal image of a 15-year-old boy with a medial tibial plateau medullary/reticular bone contusion (arrow).
Figure 2.
Figure 2.
T2-weighted fat-saturated sagittal image of a 16-year-old girl with a posterolateral tibial plateau articular impaction bone contusion (arrow). There was no cortical undulation and an absence of normal overlying articular cartilage at the site of the bone contusion.
Figure 3.
Figure 3.
Proton density–weighted fat-saturated coronal image of a 12-year-old boy with a subcortical bone contusion involving the majority of the lateral femoral condyle. Note that the overlying articular surface is preserved, unlike the articular impaction injury pattern (Figure 2).
Figure 4.
Figure 4.
Age distribution of patients with bone bruises.
See this image and copyright information in PMC

References

    1. Ariyoshi M, Nagata K, Sato K, et al. Hemarthrosis of the knee and bone contusion. Kurume Med J. 1997;44:135–139. - PubMed
    1. Atkinson PJ, Cooper TG, Anseth S, Walter NE, Kargus R, Haut RC. Association of knee bone bruise frequency with time post-injury and type of soft tissue injury. Orthopedics. 2008;31(5):440. - PubMed
    1. Boks SS, Vroegindeweij D, Koes BW, Bernsen RMD, Hunink M, Bierma-Zeinstra SMA. Clinical consequences of posttraumatic bone bruise in the knee. Am J Sports Med. 2007;35(6):990–995. - PubMed
    1. Bretlau T, Tuxoe J, Larsen L, Jorgenson U, Thomsen HS, Lausten GS. Bone bruise in the acutely injured knee. Knee Surg Sports Traumatol Arthrosc. 2002;10:96–101. - PubMed
    1. Costa-Paz M, Muscolo L, Ayerza M, Makino A, Aponte-Tinao L. Magnetic resonance imaging follow-up study of bone bruises associated with anterior cruciate ligament ruptures. Arthroscopy. 2001;17(5):445–449. - PubMed

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