Diagnostic performance is decreased following partial meniscectomy since the standard criteria used to diagnose a meniscus tear cannot be applied to the post-operative meniscus.3,4,5,6 Partial meniscectomy may distort the normal morphology of the meniscus and increased meniscal signal intensity may extend to the articular surface when a portion of the meniscus has been resected, simulating a tear. Normal variants of the meniscus APPLIED RADIOLOGY CT arthrography is a recommended alternative for patients who are not MR eligible. The meniscus is diffusely vascularized in early life but in adults, only 10-30% of the peripheral meniscus is vascularized, often referred to as the red zone. Financial Disclosure: None of the authors or planners for this educational activity have relevant financial relationships to disclose with ineligible companies whose primary business is producing, marketing, selling, reselling, or distributing healthcare products used by or on patients. Fat suppressed sagittal T1-weighted MR arthrogram (5C) demonstrates gadolinium within the tear (arrow). The congenitally absent meniscus appears to influence the development The meniscus root plays an essential role in maintaining the circumferential hoop tension and preventing meniscal displacement. MRI of the knee is commonly indicated for evaluation of unresolved or recurrent knee pain following meniscal surgery. Youderian A, Chmell S, Stull MA. FSE T2-weighted images, with a slab-like appearance on coronal images. You have reached your article limit for the month. An alternative way of fastening the allograft to the donor knee involves harvesting the meniscus with a small bone plug attached to each root and then securing the plugs within osseous tunnels drilled in the recipient tibia. ligament will help to exclude these conditions.5 In the first Reference article, Radiopaedia.org (Accessed on 04 Mar 2023) https://doi.org/10.53347/rID-40036, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":40036,"questionManager":null,"mcqUrl":"https://radiopaedia.org/articles/meniscal-root-tear/questions/1112?lang=us"}. The most frequent symptom is pain that usually begins with a minor A characteristic MRI finding to diagnose a partial tear of the medial Magn Reson Imaging Clin N Am 2014;22(4): 517555, White LM, Schweitzer ME, Weishaupt D, Kramer J, Davis A, Marks PH. (as previously described), meniscal cyst,26 discoid lateral meniscus in the same knee (Figure 9),25 and pathologic medial patella plica.27. Associated anomalies in a discoid medial According to one source, they are thought to account for ~10% of all arthroscopic meniscectomies 5. Seventy-four cases of bucket-handle tears (mean age, 27.2 11.3 years; 38 medial meniscus and 36 lateral meniscus; 39 concomitant anterior cruciate ligament (ACL) reconstruction) were treated with arthroscopic repair from June 2011 to August 2021. Monllau J, Gonzalez G, Puig L, Caceres E. Bilateral hypoplasia of the medial meniscus. This article focuses on These are like large radial tears and can destabilize a large portion of the meniscus. Discoid medial meniscus. If the tear does not show, it is considered a Grade 1 or 2 and is not as serious. Case 9: posterior root of medial meniscus, View Yuranga Weerakkody's current disclosures, see full revision history and disclosures, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, Ahlback classification system in assessing osteoarthritis of the knee joint, Kellgren and Lawrence system for classification of osteoarthritis, anterior cruciate ligament mucoid degeneration, MRI grading system for meniscal signal intensity, shortening or absence of the root on sagittal images, vertical fluid cleft on coronal fluid-sensitive (T2) images. The articular cartilage is well seen on the pre-operative sagittal proton density-weighted image (19B). This arises from the posterior horn of the lateral meniscus and attaches to the lateral aspect of the medial femoral condyle. After failing conservative management with NSAIDs, PT, and activity modification, he underwent an MRI. signal fluid cleft interposed between the posterior horn and the capsule Association of Parameniscal Cysts With Underlying Meniscal Tears as MR arthrogram fat-suppressed sagittal T1-weighted image (11C) shows no gadolinium in the repair. 1427-143. Sagittal proton density-weighted image (10A) demonstrates increased signal extending to the articular surface consistent with granulation tissue. Midterm results in active patients. Direct MR arthrography requires intraarticular injection of 20-50 mL of dilute gadolinium contrast prior to imaging which distends the joint capsule and offers a high signal to noise ratio on T1-weighted images with contrast extension into the meniscal substance indicating a recurrent tear or an unhealed repair. discoid lateral meniscus is a relatively uncommon developmental variant Pullout fixation of posterior medial meniscus root tears: correlation between meniscus extrusion and midterm clinical results. Still, many clinicians choose to use conventional MRI for initial postoperative imaging which may show displaced meniscal fragments, new tears in different locations or internal derangement not involving the meniscus. Case study, Radiopaedia.org (Accessed on 04 Mar 2023) https://doi.org/10.53347/rID-75066. medial meniscus, discoid lateral meniscus, including the Wrisberg Clark CR, Ogden JA. An intact meniscal repair was confirmed at second look arthroscopy. Arthroscopy: The Journal of Arthroscopic & Related Surgery. no financial relationships to ineligible companies to disclose. Pinar H, Akseki D, Karaoglan O, et al. Heron, D, Bonnard C, Moraine C,Toutain A. Agenesis of cruciate If missing on MR images, a posterior root tear is present. [emailprotected]. Torn lateral meniscus with superomedial and posterior flipped anterior horn. Radial Meniscal Tear - ProScan Education - MRI Online Resnick D, Goergen TG, Kaye JJ, et al. These tears are usually degenerative in nature and usually not associated with a discrete injury [. 5. The anomalous insertion About KOL ; Learn more about our technology and how more and more universities, research organizations, and companies in all industries are using our data to lower their costs. The reported prevalence is 0.06% to 0.3%.25 The sagittal proton density-weighted image (13A) demonstrates linear high signal extending to the femoral and tibial surfaces (arrow). The patient subsequently underwent successful partial medial meniscectomy. What Is a Tear of the Anterior Horn of the Lateral Meniscus? of the distal femur and proximal tibia, and in the case report of Objectives: Low-field MRI at 0.55 Tesla (T) with deep learning image reconstruction has recently become commercially available. Pre-operative fat supressed coronal proton density-weighted image (19A) demonstates a posterior root radial tear (arrow). Meniscal root tears are a type of meniscal tear in the knee where the tear extends to either the anterior or posterior meniscal root attachment to the central tibial plateau. We will review the common meniscal variants, which Complex or deep radial tears were found in three of five cases of lateral meniscus extrusion and normal root. menisci (Figure 8). Definite surfacing signal or distortion on only one image represents a possible tear. Radial tears comprise approximately 15 % of tears in some surgical series [. They divide the meniscus into superior and inferior halves (Fig. The patient had a recent new injury with increased pain. PDF ssslideshare.com A preliminary report, Principles and decision making in meniscal surgery, The Anterior Meniscofemoral Ligament of the Medial Meniscus, Accurate patient history including site and duration of symptoms, Garrett WE Jr, Swiontkowski MF, Weinstein JN, et al. At second look arthroscopy, the posterior horn tear was healed and the anterior horn tear was found to be unstable and treated by partial meniscectomy. Partial meniscectomy is by far the most common procedure. Get unlimited access to our full publication and article library. anterior horn of the medial meniscus into the anterior cruciate ligament These findings are also frequently associated with genu Neuschwander DC, Drez D Jr, Finney TP. What is anterior horn of meniscus? - KnowledgeBurrow.com A tear of the ACL should also, in practice, not be a pivoting). 2005; 234:5361. frequently. rim circumferentially, anteriorly, and posteriorly,19 which Lee S, Jee W, Kim J. treatment for stable complete or incomplete types of discoid lateral On sagittal proton-density and T2-weighted images, this lesion was demonstrated by sensitive but nonspecific signs, such as the flipped meniscus . Total meniscectomy is rarely performed unless the meniscus is so severely damaged that no salvageable meniscal tissue remains. This case is almost identical to the previous case with a different clinical history. Sagittal proton density-weighted (14A) and coronal T1-weighted (14B) images reveal a recurrent bucket-handle tear through the original repair site with typical findings of a displaced meniscal flap (arrow) into the intercondylar notch. runs from the anterior horn of the medial meniscus to either the ACL or MRI appearance of Wrisberg variant of discoid lateral meniscus. Thompson WO, Thaete FL, Fu FH, Dye SF. 6 months post-operative she had increased pain prompting follow-up MRI. The lateral meniscus is more circular, and its anterior and posterior horns are nearly equivalent in size in cross section. patella or Hoffas fat pad, and should be fairly easily differentiated Lateral Meniscus Tear | Tyler Welch, MD Recent evidence suggests that decreased extrusion may correlate to better clinical outcomes.18. Magnetic resonance imaging (MRI) is the most accurate imaging technique in the diagnosis of meniscal lesions and represents a standard tool in knee evaluation. Posterior Horn Medial Meniscus Tears - Howard J. Luks, MD We use cookies to create a better experience. For partial meniscectomies involving 25% or more, conventional MRI has lower accuracy. was saddle shaped. Bucket Handle Tear of Lateral Meniscus on MRI - A Case Report You can use Radiopaedia cases in a variety of ways to help you learn and teach.
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