@article{ref1,
title="Bone bruises in children and adolescents are not associated with ligament ruptures",
journal="Orthopaedic journal of sports medicine",
year="2018",
author="Gomez, Jorge E. and Molina, Daren D. and Rettig, Shaylon D. and Kan, J. Herman",
volume="6",
number="7",
pages="e2325967118786960-e2325967118786960",
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. <br><br>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. <br><br>METHODS: A review of clinical records and magnetic resonance imaging (MRI) findings of patients seen at a single institution was completed. <br><br>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 American 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; <i>F</i> = 3.753, <i>P</i> =.049). <br><br>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.<p /> <p>Language: en</p>",
language="en",
issn="2325-9671",
doi="10.1177/2325967118786960",
url="http://dx.doi.org/10.1177/2325967118786960"
}