{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:07:54Z","timestamp":1785434874917,"version":"3.56.0"},"reference-count":15,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009043","name":"University of Patras","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100009043","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/017wvtq80","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>A 34-year-old male presented with persistent medial knee pain and mechanical symptoms three months after a rotational injury, with limited knee extension on examination. Magnetic resonance imaging demonstrated the double posterior cruciate ligament (PCL) sign, produced by a displaced bucket-handle tear of the medial meniscus with the fragment lying anterior and parallel to the intact PCL within the intercondylar notch. Coronal sequences confirmed displacement and loss of normal meniscal configuration. Arthroscopy verified the diagnosis, and arthroscopic partial meniscectomy was performed due to chronic displacement and poor healing potential. Following structured rehabilitation, the patient returned to full athletic activity without symptoms at one-year follow-up. This case underscores the importance of recognizing the double PCL sign as a highly specific MRI finding enabling prompt diagnosis and appropriate management of displaced bucket-handle meniscal tears, while also highlighting its radiologic\u2013arthroscopic correlation and the clinical implications of delayed presentation on treatment strategy, and provides a clear illustrative example of this classic imaging sign for educational purposes.<\/jats:p>","DOI":"10.3390\/reports9020120","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T10:29:08Z","timestamp":1776162548000},"page":"120","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Double Posterior Cruciate Ligament Sign"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1398-9626","authenticated-orcid":false,"given":"Christos","family":"Koutserimpas","sequence":"first","affiliation":[{"name":"School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8350-9069","authenticated-orcid":false,"given":"Charalampos","family":"Matzaroglou","sequence":"additional","affiliation":[{"name":"School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4850-0915","authenticated-orcid":false,"given":"Konstantinos","family":"Kaliarntas","sequence":"additional","affiliation":[{"name":"School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5828-809X","authenticated-orcid":false,"given":"Evdokia","family":"Billis","sequence":"additional","affiliation":[{"name":"School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0783-5700","authenticated-orcid":false,"given":"Nikolaos-Achilleas","family":"Arkoudis","sequence":"additional","affiliation":[{"name":"Research Unit of Radiology and Medical Imaging, National and Kapodistrian University of Athens, 11528 Athens, Greece"},{"name":"Second Department of Radiology, General University Hospital \u201cAttikon\u201d, National and Kapodistrian University of Athens, Chaidari, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0122-2436","authenticated-orcid":false,"given":"George","family":"Triantafyllou","sequence":"additional","affiliation":[{"name":"Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4831-8005","authenticated-orcid":false,"given":"Maria","family":"Piagkou","sequence":"additional","affiliation":[{"name":"Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Gliatis","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, School of Medicine, University of Patras, 26504 Patra, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1007\/s00167-005-0678-x","article-title":"Meniscal bucket handle tears: A retrospective study of arthroscopy and the relation to MRI","volume":"14","author":"Ververidis","year":"2006","journal-title":"Knee Surg. 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Radiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"bcr2017222914","DOI":"10.1136\/bcr-2017-222914","article-title":"Double PCL sign on sagittal MRI of the knee","volume":"2017","author":"Hadidi","year":"2017","journal-title":"BMJ Case Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.knee.2013.09.003","article-title":"The double flipped meniscus sign: Unusual MRI findings in bucket-handle tear of the lateral meniscus","volume":"21","author":"Ahn","year":"2014","journal-title":"Knee"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Koch, J.E.J., Ben-Elyahu, R., Khateeb, B., Ringart, M., Nyska, M., Ohana, N., Mann, G., and Hetsroni, I. (2021). Accuracy measures of 1.5-tesla MRI for the diagnosis of ACL, meniscus and articular knee cartilage damage and characteristics of false negative lesions: A level III prognostic study. BMC Musculoskelet. 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