Novel Stress Radiography Technique for Assessing Medial Collateral Ligament Injuries of the Knee: A Case Report

Clinical assessment of post-traumatic ligamentous laxity is subjective, often leading to discrepancies between clinical impressions and magnetic resonance imaging (MRI) findings, particularly in collateral ligament injuries or multi-ligamentous knee injuries (MLKI). Stress radiographs provide an objective record of ligamentous laxity. We present a method for evaluating valgus knee injuries through stress radiography, illustrated by a case of MLKI involving an anterior cruciate ligament (ACL) and medial collateral ligament injury in a young adult. Initial MRI suggested isolated ACL injury; however, stress radiographs and surgical exploration confirmed the clinical suspicion. This case highlights the need for thorough clinical examination and the role of stress radiography in management decisions. Our novel technique is cost-effective and requires no specialized equipment, minimizing radiation exposure. The opening of the medial joint space measures valgus laxity directly, allowing for a side-by-side comparison to establish diagnosis and guide treatment. We demonstrate how our simple stress radiography method can be implemented in most centers while discussing various techniques from current literature.