ReviewSkeletal radiology2026
Sports injury: biomechanical approach to interpretation of knee MRI.
Review in Skeletal radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
6 authors.
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Abstract
Sports-related knee injuries are common and clinically consequential. Interpreting MR imaging through a biomechanical lens links injury patterns to the forces that produced them, improving the detection of subtle but prognostically important lesions. Characteristic osseous findings-contusions, subchondral/osteochondral fractures, and avulsions-act as "maps" of force vectors that distinguish compression from distraction mechanisms. In anterior cruciate ligament (ACL) trauma, bone bruise locations have kinematic associations (i.e., valgus-flexion-external rotation vs varus-flexion-internal rotation) and enable a targeted search for injuries involving functionally related structures, such as the menisci. The medial meniscus functions as a secondary stabilizer to anterior tibial translation. Therefore, peripheral vertical longitudinal tears and meniscocapsular ramp lesions are frequent companions of ACL rupture and may be overlooked without a mechanism-based approach. The lateral meniscus is vulnerable to radial/posterior root and peripheral capsular injuries during translational and compressive loading of the lateral compartment. Posterolateral corner structures resist varus and external rotation forces; unrecognized PLC injury compromises cruciate reconstruction and perpetuates rotatory instability. This review synthesizes biomechanical principles to provide a practical, pathophysiological framework for MRI interpretation and reporting. Applying this approach enhances diagnostic accuracy, guides surgical decision-making, and supports better outcomes for athletes with acute knee trauma. KEY POINTS: • Biomechanical principles provide a systematic framework for interpreting knee MRI after sports trauma, improving diagnostic accuracy and detection of subtle lesions. • Characteristic injury patterns on MRI often reveal the underlying traumatic mechanism, directing targeted evaluation of osseous structures, ligaments, tendons, and menisci. • Subtle injuries such as Segond fracture, ramp lesion, or posterolateral corner disruption may be overlooked without a mechanism-based interpretive approach.
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Registered trials
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