Hi all,

I have a patient whom I suspect has a partial ACL tear. The patient is a 35 year old female who 2 months ago was on a 4 hour hike where she fell 3-4 times during the hike, each time landing on her right knee. She was able to finish the hike and reported only a small effusion following the hike. At present, she is able to complete a 1 hour gym session of exercise bike, walking and other cardio based exercises, but reports mild pain in her knee towards the end of a session. She also reports difficulty with seated knee extension with an ankle weight.
Her main problem is the sensation of her knee 'giving way' at times, rather than pain. Her main reason for presenting was to get strengthening exercises for her knee.
On objective testing, medial and lateral ligaments were intact. She had greater laxity and a different end feel on anterior drawer test and lachmans test on the right knee.

I suspect she has a partial tear of her ACL. Does this history warrant a referral for an Wikipedia reference-linkMRI?

Also, is there a set of criteria for referral for an MRI or other investigation when an ACL injury is suspected?

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