The posterior cruciate ligament inclination angle is higher in anterior cruciate ligament insufficiency.

PURPOSE: Magnetic resonance imaging (MRI) is the gold standard image examination for anterior cruciate ligament (ACL) lesion diagnosis. Our hypothesis was that measuring the posterior cruciate ligament inclination angle (PCLIA) using MRI images may be an auxiliary tool to aid the recognition of ACL insufficiency. The purpose of this study was to compare the PCLIA measurement in MRIs of individuals with and without ACL injury. METHODS: The PCLIA was measured by two radiologists in 65 knee MRIs of patients with intact ACL (control group) and in 65 knee MRIs of people with ACL injury (study group). In both groups, the posterior cruciate ligament was intact. The control group was included 35 men (53.8%) and 30 women (46.1%). The patients' average age was 38.7 years (range 15-75; SD ± 14.8 years). In this group, 31 (47.6%) MRIs were from right knees and 34 (52.3%) were from left knees. The study group consisted of 45 men (69.2%) and 20 women (30.7%). The patients' average age was 36.8 years (range 14-55; SD ± 10.3 years). In this group, 33 (50.7%) were right knees and 32 (49.2%) were left knees. PCLIA was formed by the intersection of two lines drawn in MRI sagittal images. The first passed tangentially to the articular surface of the tibial condyle and the second was drawn over the fraction of the ligament that originated where the first crossed the PCL, outlined proximally. RESULTS: The average PCLIA was 44.2 ± 3.8° in the control group and 78.9 ± 8.6° in the study group. Statistical analyses showed that the PCLIA was higher in the group with ACL injury (p < 0.05). Conclusion The PCLIA was significantly higher in individuals with ACL injuries. The measurement of this angle using MRI images may allow for detection of ACL insufficiency and thus assist in an individualized and precise approach to the treatment of injuries to the ACL. CLINICAL RELEVANCE: PCLIA may be a way to detect ACL insufficiency and thus help surgeons to decide which patient might need ACL reconstruction. LEVEL OF EVIDENCE: III.

Eritema elevatum diutinum: relato de caso e revisão de literatura / Erythema elevatum diutinum: a case report and review of the literature

O eritema Elevatum Diutinum (EED)é uma vasculite leucocitoclástica crônica, de rara incidência, caracterizada por placas, pápulas e nódulos eritêmato-purpúricos, localizados principalmente nas superfícies extensoras das extremidades. A patogênese do EED é ainda desconhecida, porém sugere-se o envolvimento de mecanismos imunológicos. Relata-se o caso de uma jovem de 19 anos que há cinco meses começou a apresentar lesões eritêmato-violáceas, escamosas, localizadas na face anterior do terço médio da perna direita, ocasionalmente com prurido. Histopatológico compatível com EED. Foi instituída terapêutica com dapsona, obtendo-se evolução favorável após 10 dias e clareamento total das lesões após 5 meses. Os autores apresentam uma revisão da literatura sobre etiologia, patogenia, evolução, dignóstico clinicolaboratorial e opções terapêuticas do EED