When there is an ACL tear, particular attention should be paid on MRI to the lateral meniscus because in one study lateral meniscal root tears were found in 8% of patients with ACL tears but in only 0.8% of patients without an ACL tear . 1A–D). PMID: 7622694 12,14,15 Additionally, marginal osteophytes and cupping or flattening of the lateral tibial plateau may be revealed. Radial tears Radial tears are perpendicular to the long axis of the meniscus. The meniscal body is extruded, pushing the medial collateral ligament. In all patients, CHT involved the lateral meniscus. No medial meniscal injury was observed. The medial meniscus was systematically thicker than the lateral. They were all performed with a 1.5T MR before surgery. Associated popliteal cysts occurred in 3 knees. They start at the inner margin and go either partial or all the way through the meniscus dividing the meniscus into a front and a back piece. tears. (C) shows a discoid meniscus associated with a complex posterior horn tear. These are high energy tears. Meniscal tears may be categorized into five common configurations, including horizontal, longitudinal, radial, oblique (parrot-beak), and complex. Of 36 patients, 28 (78%) had not any history of trauma to the knee. A focal ossification of the posterior horn of medial meniscus. MRI found complete discoid medial meniscus in all four cases, with high signal intensity on a T2 weighted image suggestive of meniscal tear (Table 1, Fig. The lesion follows bone MRI signals (a; sagittal PD fat sat and b; T1 shown in this case) and this helps distinguish between a meniscal tear… Objective: To study MR findings of meniscal tears with discoid lateral menisci (DLMs) and to evaluate the incidence and accuracy of MRI compared to arthroscopical surgery.Material and methods: MR appearances of surgically proved torn discoid lateral menisci (DLM) were studied in 57 knees (40 patients). 5 Horizontal tears, the most common meniscal tear pattern, lie parallel to the tibial plateau and separate the meniscus into upper and lower parts (4a,4b). ory and evaluated the MRI findings which have been known as the findings of bucket-handle tear (BHT) and osteoarthritis. When present, it is bilateral in 20% of cases. The MRI findings of the Wrisberg variant encompass those of a discoid lateral meniscus, which include a specific measurement of the left-to-right width of the meniscus at the center of the body greater than 15 mm on a coronal slice (reference average, 12.8 mm) [3, 4]. Discoid menisci are seen far more frequently affecting the lateral meniscus than the medial meniscus, the reported ratio of lateral to medial ranging from 15:1 to 4:1. The hypointense structure on the lateral side is a discoid meniscus (blue arrow). A high-grade radial tear of the posterior horn of the medial meniscus, with almost 'ghost' appearance, extending to the posterior root. Radiology department of the Rijnland hospital in Leiderdorp, the Netherlands. The most prominent distinguishing features of discoid lateral meniscus on plain radiographs include widening of the lateral joint space and a high fibular head. Discoid meniscus is a relatively common variant of the menisci, present in ~1 in 20 pediatric knees imaged. https://orthoinfo.aaos.org/en/diseases--conditions/discoid-meniscus CONCLUSION: The characteristic MRI appearance of symptomatic discoid meniscus in children is that of a diffusely thick meniscus with a slab configuration and diffusely increased intrameniscal signal that may or may not extend to the joint surface. Results: A CHT accounts for 15% of discoid meniscus tears. They violate the collagen bundles that parallel the long axis of the meniscus. ... At first impression this looks like a tear within a discoid meniscus. Figure 9: Meniscal ossicle.
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