 Now, let us look at the mucoid degeneration of antidecruciate ligament. Now, in mucoid degeneration, there is accumulation of musinous material within the ligament and as a result of which the ligament can have three different appearances. One is a predominantly mucoid ACL where the ligament itself is very much hyper intense and bulky. The other one is mucoid ACL along with cystic degeneration or there is a ganglion cyst which is forming at the femoral attachment along with mucoid degeneration of ACL. And the third one is a predominantly cystic type where you can see a large ganglion cyst at the femoral attachment where the ligament fibers themselves do not show much of degeneration changes. Now, how do you differentiate a mucoid ACL from an ACL tear? In ACL tear, if you draw lines like this along the fibers, you will see that there is a complete disruption or a discontinuity in the line and there will be a fluid signal intensity in this region which is nothing but a tear. In case of a mucoid ACL, you can actually identify the fibers all along so you will not see any disruption of these lines just that the lines will appear more fuzzy but you can appreciate them very well. So this is nothing but your mucoid ACL. In a mucoid ACL, you need to mention the grade of degeneration which is mainly on eyeballing so this is your mild degeneration, this is moderate and this is your marked mucoid degeneration. In mucoid ACL, you tend to develop ganglionsis at multiple levels. So in this patient, there is a multi-loculated ganglion cyst at the femoral attachment. This patient has an intrasubstance ganglion cyst formation and if you will see that one of the bundle is very good. So this is actually a mucoid ACL involving a single bundle and there is an intrasubstance ganglion cyst and in this patient, there is a small ganglion cyst forming at the femoral attachment as well as at the tbl attachment. So you need to mention at what level you are seeing the ganglion cyst. Also, in mucoid degeneration, as I have already told you, there is accumulation of miscellaneous material. Now this miscellaneous material tends to take the path of least resistance. Sometimes, when the ligament itself provides a lot of resistance, this miscellaneous material enters into the bone and hence what you get is introspecistic changes. So here this patient has introspecistic changes at the femoral attachment, here there is at the tbl attachment and this patient predominantly has some small cystic changes as you can see over here but mainly there is a lot of marrow edema at the tbl attachment of ACL. Now when the mucoid degeneration or the accumulation of miscellaneous material happens rapidly, this miscellaneous material will go enter rapidly into the bone and there won't be a time for development of a cyst. Instead, it will result into bone marrow edema changes that is the bone will give some reaction to it. So, if you see a mucoid degenerated ACL and the bone marrow edema at the tbl or femoral attachment, please keep in mind that this can happen with mucoid degeneration before labeling it into as some other pathology. So this is an x-ray of a patient, an api radiograph and what you can see is a lytic area at the intercondylar eminence with sclerotic margins. Now this patient was actually reported as an incontromine, this patient had come for a biopsy but when we looked at the MRI images also on MRI it was reported as an incontromine but if you see there is a degenerated ACL and these are nothing but multi-loculated introspecistic changes at the tbl attachment of ACL. So the biopsy was not done on this patient and therefore this is very important to keep in mind that please remember there is an entity like an introspecistic changes that happens with ACL and it should not be labelled as some other pathology like a tuber or something because the patient will land up with further investigations. So in any mucoid ACL report you need to mention the status of the ligament that is what is the grade of the degeneration, the ganglion cyst if there is any and at what level it is and the introspecistic changes. Thank you for watching the video and I hope by now you've got an idea how to differentiate between mucoid degeneration of ACL and ACL injuries. We'll be coming soon with the video on posterior cruciate ligament pathologies and in the meantime if you like the video please hit the like button and put in the queries and comments in the comment section and we'll get back to you. Thank you and keep reporting.