Dr. Jordan Leith, MD, MHSc, FRCPC, Orthopedic Surgeon, discusses MCL (Medial Collateral Ligament) knee injuries.

Larissa Roux, MD FRCP Dip Sport Med, MPH, PhD, discusses MCL tears in hockey.

An MCL sprain is an injury to the medial collateral ligament of the knee. A sprain defines that it’s a ligament, and it’s a stretching injury to ligaments.

Looking on a model of the knee, again, we’ve got the kneecap, your thighbone, your shinbone. This is the medial side of the knee and the lateral side of the knee. The medial collateral ligament is this structure that runs along the medial side of the knee, and it stops the knee from opening medially.

So when you injure the medial collateral ligament, you stretch this ligament. It usually is injured from a blow to the lateral side of the knee that causes the stretch to the medial collateral ligament.

That’s what results in a medial collateral ligament sprain. There’s a number of degrees of sprains, from 1 to 3, 3 being the worst, which is a complete tear of that ligament.

The majority that we see are Grade 1 and 2, and they’re just a stretch and a little more significant stretch. They’re usually treated non-surgically. They rarely require surgery. If you do have a medial collateral ligament sprain, you will have pain along the medial side of your knee. You will have some swelling. You will have stiffness.

The best way to treat them initially is with ice and rest and anti-inflammatories. You should potentially see your family doctor if these symptoms are more significant.

Your family doctor may choose to refer you to a physiotherapist for treatment. If physiotherapy does not relieve your symptoms within the first six to eight weeks, then you may be best to be referred to a surgeon.

If you have any questions regarding an MCL injury or you think you have an MCL injury that you have further concerns about, then I would seek consultation with your family doctor.

Video Title: MCL (Medial Collateral Ligament) knee injuries.

Presenter: Dr. Jordan Leith, Orthopaedic Surgeon, Burnaby, BC

Local Practitioners: Orthopaedic Surgeon

The MRI is the best way to look at disc herniations and to see the effect of the herniation on the nerve roots. We can see disc herniations with CT as well but we can’t identify the exact relationship to the nerve roots, or to the spinal cord higher up in the spine.

So there is much greater detail with MRI. This is an example of a lumbar spine MRI on an ahtlete who plays hockey and there are the normal disc spaces within the spine.

At this level the disc space is lost and we can see disc material extending into the spinal canal. This is a very large disc herniation that is pressing on the nerve roots within the spinal canal. The CT scan demonstrates the bones nicely and is very helpful if we’re concerned of a spine fracture.

What we don’t see as well on CT are the soft tissues, particularly in the lower lumbar spine there can be quite a bit of artifact and the detail within the disc herniation is not as well seen.

In particular we don’t see the impingement or compression of the nerve roots with CT, nor do we see the spinal cord with CT, so MRI gives us much better resolution.

The other benefit of MRI, we can view the anatomy in multiple planes. This is an axial image of the same area the disc herniation can be seen here. It’s a very large disc herniation. What MRI can do for us is identify the nerve roots which are not seen specifically with CT. We can identify the degree of compression of the nerve roots.

The detail shown with MRI helps the surgeon decide whether surgery is needed for disc herniation or just if conservative management is sufficient. If you have any questions about lumbar spine MRI contact your family doctor or an imaging center.

Presenter: Dr. Audrey Spielmann, Radiologist, Vancouver, BC

Local Practitioners: Radiologist