Diagnosing PCL Injuries: History, Physical Examination, Imaging Studies, Arthroscopic Evaluation

Background: The posterior cruciate ligament (PCL) is a vital component for knee stability, and injuries to this ligament can significantly impact an individual's mobility and quality of life. PCL injuries typically occur due to high-impact activities, such as sports or vehicle accidents, where the knee is subjected to excessive stress. Understanding the mechanisms of injury, clinical manifestations, and effective diagnostic methods for accurately identifying and treating PCL injuries is essential. The aim of this study is to provide an overview of the diagnostic process for PCL injuries, including taking a medical history, physical examination, imaging studies, and arthroscopic assessment. Methods: The authors conducted a comprehensive literature review on diagnosing PCL injuries, focusing on established clinical practices and emerging diagnostic techniques from ۲۰۰۹ to ۲۰۲۱. The assessment process begins with a detailed medical history to determine the circumstances surrounding the injury, followed by a systematic physical examination using specific tests, such as the posterior drawer test and the sag sign, to evaluate ligament integrity. Imaging studies, especially MRI, are highlighted as the gold standard for confirming PCL injuries and assessing damage to related intra-articular structures. This study also discusses the role of arthroscopic evaluation in providing direct visualization of the ligament and assessing the extent of the injury. Results: Results indicate that accurate diagnosis of PCL injuries heavily relies on a combination of thorough medical history, physical examination, and appropriate imaging. The posterior drawer test, with a reported sensitivity of ۹۰% and specificity close to ۹۹%, is the most sensitive clinical tool for diagnosing PCL laxity. Other important tests include the active quadriceps test and the Godfrey test, which help differentiate between isolated PCL injuries and additional ligamentous injuries. MRI is a definitive imaging method capable of demonstrating tears and assessing concomitant meniscal or cartilage damage. This study emphasizes that while imaging plays a crucial role in diagnosis, clinical examination should not be overlooked as it can often provide immediate insights into the nature of the injury. Conclusion: In conclusion, diagnosing PCL injuries requires a multifaceted approach integrating patient history, physical examination findings, imaging studies, and potential arthroscopic assessment. The combination of these methods enhances diagnostic accuracy and informs treatment decisions. Since PCL injuries can often be misdiagnosed or overlooked due to their subtle presentations, healthcare providers must remain vigilant in their evaluation efforts to ensure timely and effective management.