Double PCL Sign

Fig: Sagittal PD image of the knee shows 'double PCL sign'. Note the 'extra' dark band (arrows) beneath the true posterior cruciate ligament (arrowheads). This dark band represents 'bucket-handle tear of meniscus'. Joint effusion is marked by a red star.

Double PCL Sign

• Displaced fragment of meniscus in the intercondylar notch of the knee, resembling two posterior cruciate ligaments (PCL)
• Sign of bucket-handle meniscal tear
• Usually tear occurs in young active person
• Medial meniscus > lateral meniscus
• Confirmation on coronal image that shows displaced fragment in the notch
• Look for concomitant chronic ACL tear
  

Reference:
Stoller DW, et al. Diagnostic imaging: orthopedics. 2004