A deep lateral femoral notch as a sign of acutely torn anterior cruciate ligament

Anterior cruciate ligament (ACL) tears are frequently associated with abnormalities of the lateral femoral condyle as shown by magnetic resonance imaging. The mechanism of injury has been described as due to bone compression during knee trauma. This may lead to compression of the lateral condylopatellar notch (sulcus). It has been suggested that detection of a deep notch on the plain lateral radiograph is a useful indirect sign of ACL tear. Depth of this notch was measured in 34 consecutive prospective patients assessed as having acute ACL tear clinically and proven at arthroscopy. In no patient was the notch deep, suggesting that this is not a useful sign in acute tears of the anterior cruciate ligament.