The Effectiveness of the "Notch Sign" For Diagnosing Anterior Cruciate Ligament Injuries
L.C.H. Macedo, C.P. Helito, M.G.D.S. Leão, I.C.G.D.O. Andrade, C.D.A. CostaOBJECTIVES:
This study aimed to analyze the effectiveness of the notch sign as a predictor for ACL injuries.
METHOD:
A prospective, observational study - accuracy study, was carried out in patients who suffered some torsional trauma to the knee and were diagnosed with knee instability or meniscal injury. The lateral radiography of the patients' knees was evaluated, trying to find and measure the femoral notch sign.
RESULTS:
Of the total number of patients seen in the study, 30 had a notch sign test >1.5mm and were ACL deficient, which produced an accuracy of 34% and a specificity of 100%. Of these, 86.7% (26/30) are male and have an average age of 30.5, ranging from 19 to 52 years. The largest number of injuries occurred in the right knees (56.7% - 17/30) and the main accident mechanism was sports (86.7% - 26/30), the majority of which were football players (69.2% - 18/26). Regarding the diagnosis, the majority of patients had an association between the ACL injury and the medial meniscus and lateral meniscus (30.0% - 9/30), followed by those with an association only with the medial meniscus (26.7% - 8/30).
CONCLUSION:
The notch sign tool is useful and very specific for diagnosing anterior cruciate ligament injuries; its presence on lateral radiography is, although infrequent, pathognomonic.