anterior horn lateral meniscus tear: mri

MRI plays a critical role in influencing the treatment decision and enables information that would obviate unnecessary surgery including diagnostic arthroscopy. Case study, Radiopaedia.org (Accessed on 04 Mar 2023) https://doi.org/10.53347/rID-75066. described in thrombocytopenia absent radius syndrome (TAR syndrome).2,3 Bilateral hypoplasia of the medial meniscus has also been reported.4. Meniscal surgery is common and requires accurate post-operative imaging interpretation to guide the treatment approach. The torn edges are aligned, and stable fixation applied with sutures or bioabsorbable implants at approximately 5 mm intervals. The camera can visualize the meniscus and other structures within the knee. this may extend to to the mid body." is this a bucket tear? Is sport activity possible after arthroscopic meniscal allograft transplantation? This is a critical differentiation because the latter represents meniscal tears that can be 4). According to these authors, increased signal to the surface on only one slice should be interpreted as a possible tear. Cases of only one abnormal slice correlated to tears at arthroscopy 55 % of the time for the medial meniscus and 30 % for the lateral [, Accuracy of diagnosing meniscus tear with these criteria has been good. Radiology. The tear was treated by partial meniscectomy at second surgery. Unable to process the form. The remaining 42 cases were located in the red zone (19 cases) or the red-white zone. Lateral Meniscus: Anatomy The lateral meniscus is seen as a symmetric bow tie in the sagittal plane on at least one or two sections before it divides into two asymmetric triangles near the midline. Klingele KE, Kocher MS, Hresko MT, et al. Variations in meniscofemoral ligaments at anatomical study and MR imaging. structure on sagittal images on T1, proton density, and fat-saturated 1427-143. Tears Weight-bearing knee X-rays showed a 50 % narrowing in the medial compartment. Proper preoperative sizing of the allograft is critical for surgical success and usually performed with radiographs. meniscus are not uncommon; they include an anomalous insertion of the medial meniscus, discoid lateral meniscus, including the Wrisberg Discoid lateral meniscus (DLM) is a common anatomic variant in the knee typically presented in young populations, with a greater incidence in the Asian population than in other populations. Anatomic variability and increased signal change in this area are commonly mistaken for tears. MR imaging and MR arthrography for diagnosis of recurrent tears in the postoperative meniscus. Radiographic knee dimensions in discoid lateral meniscus: Comparison with normal control. that this rare condition is also clinically asymptomatic. Discoid lateral meniscus of the knee joint: Nature, mechanism, and operative treatment. The meniscus can separate from the joint capsule or tear through the allograft. Most horizontal tears extend to the inferior articular surface. The diagnosis of tears of the anterior horn of the meniscus by magnetic resonance imaging (MRI) is sometimes different from that obtained by arthroscopic examination. There was no history of a specific knee injury. What is your diagnosis? Intensity of signal contacting meniscal surface in recurrent tears on MR arthrography compared with that of contrast material. Clinical History: An 18 year-old male with a history of a posterior horn medial meniscus peripheral longitudinal tear treated with meniscal repair at age 16 presents for MR imaging. congenital anomalies affect the lateral meniscus, most commonly a This case features the following signs of meniscal tear: absent bow tie appearance of the lateral meniscus ghost meniscus: empty location of the anterior horn of the lateral meniscus Atypically thick and high location AJR Am J Roentgenol. 22 year-old male with a history of ACL and MCL reconstruction and medial meniscus posterior root repair. This article focuses on trials, alternative billing arrangements or group and site discounts please call While they can arise from a number of mechanisms, root tears are generally thought to be chronic 5. the intercondylar notch, most commonly to the mid ACL, and less commonly intra-articular structures at 8 weeks gestation. Each meniscus attaches to the tibia bone in the back and front via the "meniscal roots." The primary role of the meniscus is to serve as a shock-absorber and protect the underlying articular cartilage and bone. Radial tears comprise approximately 15 % of tears in some surgical series [. Healed peripheral medial meniscus posterior horn repair and new longitudinal tear in a different location. Become a Gold Supporter and see no third-party ads. an adult), and approximately twice the size of the anterior horn on Kim EY, Choi SH, Ahn JH, Kwon JW. It can be divided into five segments: anterior horn, anterior, middle and posterior segments, and posterior horn. On the proton density-weighted image (12A) persistent high signal extends to the tibial and femoral surfaces (arrow). Kelly BT, Green DW. Note that signal does not contact articular surface, The most common criterion for diagnosing meniscus tear on MRI is an increased signal extending in a line or band to the articular surface. RESULTS. The intrameniscal ligament where it diverges from the back of the anterior horn of the lateral meniscus is also a common area misinterpreted as a tear. Shepard et al conclude that with a 74% false-positive rate, anterior horn tears should be treated surgically only if clinical correlation exists. Longitudinal medial meniscus tear managed by repair (arrow). Papalia R, Vasta S, Franceschi F, D'Adamio S, Maffulli N, Denaro V. Meniscal Root Tears: From Basic Science to Ultimate Surgery. Additionally, the postoperative complication of new extensive synovitis is apparent on the axial view (18D). Root tears are associated with a high risk for osteoarthritis. Both the healed peripheral tear and the new central tear were proved at second look arthroscopy. the example shown (Figures 1 and 2), the entire medial meniscus is Am J Sports Med. FSE T2-weighted images, with a slab-like appearance on coronal images. The aim of this study was to evaluate diagnostic values involved in conventional magnetic resonance imaging (MRI) features of MM posterior root tears (MMPRTs) and find other MRI-based findings in patients with partial MMPRTs. include hypoplastic menisci, absent menisci, anomalous insertion of the Discoid lateral meniscus in children. Radial or oblique tear congurations close to or within the meniscus . 2012;199(3):481-99. Congenital discoid cartilage. also found various MRI characteristics highly specific for detection of a recurrent tear including a line of intermediate-to-high signal or high signal through the meniscus extending into the articular surface on T2-weighted images with 95.8% specificity and change in the signal intensity pattern through the meniscus on intermediate weighted or T2-weighted images when compared to the baseline MRI with 98.2% specificity. Indirect MR arthrography is less commonly used and relies on excretion of intravascular gadolinium into the joint through synovial cells after intravenous administration of gadolinium contrast 20-90 minutes prior to the MRI exam. We use cookies to create a better experience. Sagittal proton density-weighted image (10A) demonstrates increased signal extending to the articular surface consistent with granulation tissue. in this case were attributed to an anterior cruciate ligament tear Vertical flap (oblique, flap, parrots beak) tears are unstable tears and occur in younger patients. Evaluation of postoperative menisci with MR arthrography and routine conventional MRI. Arthroscopy evaluation found a lateral meniscus peripheral (red-white zone) longitudinal tear. Studies on meniscus root tears have investigated the relationship of osteoarthritis and an anterior cruciate ligament tear. The condition is typically asymptomatic and, therefore, is infrequently diagnosed.14 The post arthrogram view (13B) reveals gadolinium within the repair site. An MRI of plaintiff's left knee conducted in May 2018 demonstrated a complex 7 tear of the posterior horn of the lateral meniscus and a suspected horizontal tear of the anterior horn of the lateral meniscus. varus deformity (Figure 3). On imaging alone, the radiologist may not be able to distinguish a residual tear (failed repair) from a recurrent tear in the same location. Meniscal disorders: Normal, discoid, and cysts. Lateral meniscus extrusion was present in six (23%) of 26 LMRTs and five (2.2%) of 231 patients with normal meniscus roots ( P < .001). Findings indicate an intact meniscus following partial meniscectomy with normal intrameniscal signal. However, the use of MRI arthrography should be considered for post-operative menisci with equivocal findings on conventional MRI as the presence of high gadolinium-like signal within the meniscus would allow for a definitive diagnosis of re-tear. Torn lateral meniscus with superomedial and posterior flipped anterior horn. By continuing to use our site, you consent to the use of cookies outlined in our Privacy Policy. Fat supressed coronal proton density-weighted (19C, D) and sagittal proton density-weighted (19E) images demonstrate postoperative changes from interval posterior horn partial meniscectomy with a thin rim of posterior horn remaining (arrow) and subchondral fractures in the medial femoral condyle and medial tibial plateau (arrowheads) with marked progression of full-thickness chondral loss in the medial compartment and extruded meniscal tissue. At the time the case was submitted for publication Mostafa El-Feky had no recorded disclosures. Tears of the anterior horn of the medial meniscus, an inferior patella plica, and ACL tears can be mistaken for AIMM, but carefully tracing the ligament will help to exclude these conditions. (as previously described), meniscal cyst,26 discoid lateral meniscus in the same knee (Figure 9),25 and pathologic medial patella plica.27. of the AIMM into the ACL is classified as Type 1 (inferior third), Type 2 Radiology. MRI of the knee is commonly indicated for evaluation of unresolved or recurrent knee pain following meniscal surgery. Thirty-one of these patients underwent subsequent arthroscopic evaluation to allow clinical correlation. The knee is a complex synovial joint that can be affected by a range of pathologies: ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. This has also been described as grade 2 signal [, Sagittal fat-suppressed T2 image of a 14-year-old patient showing a grade 2 signal in the posterior horn of the medial meniscus (PHMM). MRI features are consistent with torn lateral meniscus with flipped anterior horn superomedial and posterior, resting superior to the posterior horn. asymptomatic, although there is a greater propensity for discoid menisci found that the absence of a line of increased signal through the meniscus extending to the articular surface on proton density and T2-weighted images was a reliable MRI finding for an untorn post-operative meniscus with 100% sensitivity. Am J Sports Med 2016; 44:625632, De Smet AA, Horak DM, Davis KW, Choi JJ. Tachibana Y, Yamazaki Y, Ninomiya S. Discoid medial meniscus. History of longitudinal medial meniscus tear managed by meniscal repair (arrows). Another MRI was later performed due to worsening symptoms, and demonstrated a bucket-handle tear with complete anterior luxation of the posterior horn of the left lateral meniscus (Figs. Youderian A, Chmell S, Stull MA. The MRI revealed a vertical flap (oblique) tear of the medial meniscus. Anomalous Medial meniscus posterior horn peripheral longitudinal tear treated with repair. Dr. Diduch, Associate Professor, Department of Orthopaedic Surgery, University of Virginia School of Medicine, Charlottesville, VA, is Editor of Sports Medicine Reports. The lateral meniscus is more circular, and its anterior and posterior horns are nearly equivalent in size in cross section. Examination of the knee showed a mild effusion, 1+ Lachman, positive Pivot shift, and mild tenderness to both medial and lateral joint lines. The shape of the meniscus is formed at the eighth week of Most patients are asymptomatic, but injury to the meniscus can Kim SJ, Choi CH. Discoid medial menisci are much less common than discoid lateral menisci,24 and they may be bilateral.

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