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you are now listening to nailed it the orthopedic surgery podcast [Music] what are some of the you know what are some of the telltale signs that this is an acl what are you looking for and i guess if you could describe these images and kind of what you see that that that clues you in absolutely yeah so for an acl tear if im thinking acl from the patients history and i go pull it up im starting with what youre seeing on the left which is a t2 sagittal based image because i think the t2 image is really nice for two reasons number one you know your expected appearance of the acl so you can look for it and number two and more importantly you can see a pivot shift bone boost pattern to the underlying bone from the shifting mechanism of the tibia going forward and externally rotating and coming back in so youre going to see that distal lateral femoral condyle bone bruise and the posterior lateral tibial plateau having a corresponding kissing lesion of bone bruising on it and so ill pu