Lateral femoral notch sign (knee)
Updates to Article Attributes
The (deep) lateral femoral notch sign describes a depression on the lateral femoral condyle at the terminal sulcus, a junction between the weight bearing-bearing tibial articular surface and the patellar articular surface of the femoral condyle.
Pathology
The likely mechanism is a hyperextension or impaction injury with a collision of the femoral condyle and the posterior tibial plateau during the rotational movement responsible for injuring the ACL, most commonly the pivot-shift.
Radiographic appearance
Lateral femoral notch sign is usually first appreciated on the lateral radiograph and is suggestive of an osteochondral fracture 1-2,2. The depth of the lateral femoral notch sign has been shown to correlate with anterior cruciate ligament (ACL) tear 2.
A normal sulcus is located is located within 10mm10 mm of Blumensaat's line onlateral projection 3.
Plain radiograph
On a lateral projection, a line is drawn from the normal articular surface of the lateral femoral condyle. The depth of the abnormal depression/notch can then be measured. A study compared the depth of the lateral femoral notch in patients with proven ACL tear and healthy individuals. A notch depth of 1.5 mm is shown as a useful additional sign of a torn ACL 2.
Internal derangement should also be suspected if the notch is irregular.
-<p>The <strong>(deep) lateral femoral notch sign </strong>describes a depression on the lateral femoral condyle at the terminal sulcus, a junction between the weight bearing tibial articular surface and the patellar articular surface of the femoral condyle.</p><h4>Pathology</h4><p>The likely mechanism is a hyperextension or impaction injury with a collision of the femoral condyle and the posterior tibial plateau during the rotational movement responsible for injuring the ACL, most commonly the pivot-shift. </p><h4>Radiographic appearance</h4><p>Lateral femoral notch sign is usually first appreciated on the lateral radiograph and is suggestive of an osteochondral fracture <sup>1-2</sup>. The depth of the lateral femoral notch sign has been shown to correlate with <a href="/articles/anterior-cruciate-ligament-tear">anterior cruciate ligament (ACL) tear</a> <sup>2</sup>. </p><p>A normal sulcus is located is located within 10mm of <a title="Blumensaat's line" href="/articles/blumensaat-line-1">Blumensaat's line</a> on lateral projection <sup>3</sup>.</p><h5>Plain radiograph</h5><p>On a lateral projection, a line is drawn from the normal articular surface of the lateral femoral condyle. The depth of the abnormal depression/notch can then be measured. A study compared the depth of the lateral femoral notch in patients with proven ACL tear and healthy individuals. A notch depth of 1.5 mm is shown as a useful additional sign of a torn ACL <sup>2</sup>.</p><p>Internal derangement should also be suspected if the notch is irregular.</p>- +<p>The <strong>(deep) lateral femoral notch sign </strong>describes a depression on the lateral femoral condyle at the terminal sulcus, a junction between the weight-bearing tibial articular surface and the patellar articular surface of the femoral condyle.</p><h4>Pathology</h4><p>The likely mechanism is a hyperextension or impaction injury with a collision of the femoral condyle and the posterior tibial plateau during the rotational movement responsible for injuring the ACL, most commonly the pivot-shift. </p><h4>Radiographic appearance</h4><p>Lateral femoral notch sign is usually first appreciated on the lateral radiograph and is suggestive of an osteochondral fracture <sup>1,2</sup>. The depth of the lateral femoral notch sign has been shown to correlate with <a href="/articles/anterior-cruciate-ligament-tear">anterior cruciate ligament (ACL) tear</a> <sup>2</sup>. </p><p>A normal sulcus is located within 10 mm of <a href="/articles/blumensaat-line-1">Blumensaat's line</a> on lateral projection <sup>3</sup>.</p><h5>Plain radiograph</h5><p>On a lateral projection, a line is drawn from the normal articular surface of the lateral femoral condyle. The depth of the abnormal depression/notch can then be measured. A study compared the depth of the lateral femoral notch in patients with proven ACL tear and healthy individuals. A notch depth of 1.5 mm is shown as a useful additional sign of a torn ACL <sup>2</sup>.</p><p>Internal derangement should also be suspected if the notch is irregular.</p>
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