Misdiagnosed cartilaginous PCL avulsion in young children

Posterior Cruciate Ligaments injuries are rare in children and usually due to bony avulsion fractures or midsubstance tears. This study focused on cartilaginous avulsions initially misdiagnosed despite of MRI assessment. Two 6-year-old boys had cartilaginous avulsion fracture injury at the femoral attachment of the PCL. One had associated medial meniscal lesion and was reinserted. The other conducted to non-union. MRI second lecture reveals an original description with nail-biting sign on cartilage surface of anterior notch, and a close PCL angle without anterior tibial translation. No bone bruise was associated. Similarly, to ACL cartilaginous tibial avulsions, PCL cartilaginous femoral avulsions are underdiagnosed. When knee hemarthrosis occurs under the age of nine, clinician and radiologist should be aware that cartilaginous avulsion of ACL and PCL also could be the main pattern of lesion.