During the last few decades, as the management of meniscal trauma has evolved, and knowledge gained on meniscal function, the orthopaedic surgeon has attempted to preserve the meniscus whenever possible. How to read knee mri of medial meniscus tear video. Robert laprade details the specifics on how to read knee mri of medial meniscus tear. The tibial intercondylar eminence can limit inward. Sports injury medicine department 9250 sw hall blvd. Mri has high sensitivity and specificity for detecting meniscal tears in older patients, and ultrasound imaging is almost as good. For each finding and diagnosis, the book provides a complete list of differential diagnoses as well as the features that will help the clinician differentiate diseases.
When a radial tear is present in the posterior root of the lateral meniscus, the appearance may be the same. Meniscus stock photos download 1,484 royalty free photos. The value of standard radiography is extremely limited for the assessment of meniscal injuries but may be indicated to obtain a. Clinical examination, mri and arthroscopy in meniscal and. Mr appearances of surgically proved torn discoid lateral menisci dlm were studied in 57 knees 40 patients. Commonest type of tear in lateral meniscus was horizontal tear 42. Meniscus tears are among the most common knee injuries. This book, published in cooperation with esska, provides an exhaustive. This disparity in motion contributes to the frequency in which each meniscus is injured. The meniscus sits between the cartilage surfaces of the bone to distribute weight and to improve the stability of the joint.
The meniscus is a type of cartilage in your knee joint. Knee tuner is designed to help you maintain strong, healthy knee joints. 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. Extends from the inner free edge of the meniscus and runs perpendicular. On mri, this tear pattern manifests as a full thickness vertical peripheral tear in the redred zone of the medial meniscal posterior horn via linear high t2 fluid intensity signal extending from. According to one source, they are thought to account for 10% of all arthroscopic meniscectomies 5. Buckethandle tears are usually longitudinal tears of the menisci with an attached fragment displaced away from the meniscus.
Feb 01, 2017 incidental meniscal findings on mri scan of the knee are common in the general population and increase with increasing age. Mr imaging of meniscal tears with discoid lateral meniscus. Medial meniscus posterior root tears mmprts disrupt the continuity of the circumferential fibers, leading to loss of hoop tension, loss of loadsharing ability, abnormal rotation of the tibia, and unacceptable peak pressures 1,2,3,4. Pdf magnetic resonance imaging in the evaluation of meniscal tear. It is well established that meniscal damage predisposes the adjacent articular cartilage to increased axial and sheer stress, resulting in early degenerative osteoarthritis. May 19, 2008 data from 565 knee arthroscopies performed by two experienced knee surgeons between 2002 and 2005 for degenerative joint disorders, ligament injuries, loose body removals, lateral release of the patellar retinaculum, plica division, and adhesiolysis was prospectively collected. Some of the tears located in one part were noted extending to other parts of meniscus. Learn what happens when you tear your meniscus and how these tears are treated. A common injury among elite, recreational, and youth athletes is the anterior cruciate ligament acl tear. Mr imagingbased diagnosis and classification of meniscal. Mri has been found to be extremely useful in diagnosing displaced meniscal tears, particularly, the buckethandle tears. Mri gives a good picture of the size of a meniscus tear and where it is. Meniscus tear article about meniscus tear by the free. Meniscal function is essential to normal function of the knee joint when the menisci is removed the joint contact area is reduced by 40% the contact area is 2.
The majority of missed meniscus tears on mri affected the peripheral posterior horns. There are three basic mr characteristicscriteria of meniscal tears 5. Diagnosis of meniscal tear is always challenging even with high strength mri. Doctor answers on symptoms, diagnosis, treatment, and more.
The last bone we need to add if we are building a knee is the patella. Medial meniscus tear knee mri mri brain radiology imaging nuclear medicine medical anatomy knee surgery neurology nursing notes. Chris centeno goes over what to look for on your mri and the different types of meniscus tears. When doctors and patients refer to torn cartilage in the knee, they actually may be referring to an injury to a meniscus at the top of one of the tibiae. Rehabilitation is suggested as the primary treatment option for young adults following an acute acl tear. They often tend to be radial tears extending into the meniscal root. Optimizing recovery after knee meniscal or cartilage. Some technical advances have improved the diagnostic capabilities of mri so that diagnoses, which may change the therapeutic approach, such as a partial tear of the anterior cruciate ligament or confirmation of unstable meniscal injuries, are now made easier. Menisci can be torn during innocuous activities such as walking or squatting. In 1948 fairbank first reported the roentenographic changes after meniscectomy. Arthroscopic outsidein technique reported in the literature by warren and more recently. While mris can help your doctor make a diagnosis, they arent considered 100 percent. Knee cartilage injuries including meniscal tears doctor.
Meniscal tear arthroscopic view of tear regenerated meniscus 6. Accurate and timely diagnosis of a meniscal tear is critical for reducing morbidity and planning treatment. Powerpoint presentation about 5 minutes long on a surgery i witnessed. The mri diagnosis performance is high specificity and sensitivity in diagnosing meniscal tears is high, with a sensitivity of 93. Most meniscal injuries, anterior cruciate ligament and lateral collateral. Case study meniscus tears and osteochondral fractures. This clinical guide provides a special focus on the normal meniscal mechanism, body and function. The meniscus plays a critical role in maintaining the well being of our knees.
Mri is a highly accurate imaging method for diagnosing meniscal tears. The prevalence of asymptomatic tears, which typically are horizontal tears, increases with age 1,2. It has been shown that meniscal tears are exclusively mribased in. Preliminary diagnosis of medial meniscus posterior root. It is also common for the meniscus to be damaged in association with injuries to the anterior cruciate ligament.
Occasionally it can be difficult to diagnose a tear in a discoid meniscus on mri because the meniscus may have diffuse internal signal that contacts one or both articular surfaces of the meniscus without the presence of a tear. Xrays may be necessary, to rule out broken bones and other problems. Jun 16, 2012 injury a 20 year old male track athlete 5k and 10k distance events 3 years prior, consistent discomfort and pain along l medial joint line 4 weeks prior, escalated to extreme pain spoke with atc and consulted physicians preoperative exam and mri revealed a medial meniscus tear did not respond well to conservative. The sensitivity of mri for detecting meniscal tears at the anterior horn, body, posterior horn and overall.
Mri made easy for beginners 2nd edition pdf magnetic. The factors contributing to missed meniscal tear in the setting of acl injury are the performance of the mri assessment shortly after the traumatic event, small of the tear i. Ayurvedic treatment for meniscal tear doctors answer your. Evaluation of traumatic knee joint injuries with mri. Clinical diagnostic tests versus mri diagnosis of acl tears. Download 1,484 meniscus stock photos for free or amazingly low rates. Meniscal tears are one of the most frequently reported injuries to the knee joint. 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. Knee meniscus rupture an overview sciencedirect topics. Meniscal tears isolated to the posterior root of the lateral meniscus can be subjectively difficult to evaluate because of the anterior oblique course of the posterior root attachment. Mri made easy for beginners 2nd edition pdf for free. Nonabsorbable 20or0 interrupted suture is used to repair the meniscus tear to adjacent meniscal tissue or the peripheral capsule. A concise reference for everyday practice practical differential diagnosis in ct and mri is a onestop resource for the differential diagnosis of common and rare radiologic findings and conditions in all regions of the body. Any information contained in this pdf file is automatically generated from digital material.
Work with your doctor to plan a rehabilitation rehab program that helps you regain as much. Racgp meniscal tear presentation, diagnosis and management. Surgery versus physical therapy for a meniscal tear and. Pdf magnetic resonance imaging of meniscal and cruciate injuries. A guide to evaluation and reporting is a wellwritten, uptodate book covering all imaging aspects of magnetic resonance mr imaging of the knee joint.
The exact role that the meniscus cartilages play in the function of the knee is poorly understood, but they do not act as a cushion between the femur and tibia, as many of us were taught see sidebar. The menisci are especially vulnerable to injuries in which there is both compression and twisting applied across the knee. The meniscus is a tough, rubbery piece of cartilage that acts as a shock absorber between your femur and tibia on both the medial and lateral aspects of your knee. How to read an mri of a medial meniscus tear minnesota. Mar 22, 2017 in the two most recent series, meniscus mri and mri of the supporting structures, we focus on two important areas of assessment. To avoid errors in diagnosing meniscal tears, those interpreting mr examinations of the knee need to be aware of the attachments of the menisci and the normal variations in meniscal anatomy that may resemble a meniscal tear. Meniscal bucket handle tear flipped meniscus radiology. Researchers utilize mri to investigate how tears heal. Horizontal tear was commonest 12% followed by complex tear 11%, bucket handle tear 07%, radial tear 3% and longitudinal tear 2% in medial meniscus. Reliability of clinical diagnosis in meniscal tears. Accuracy of mri in the diagnosis of meniscal tears in.
Mri is often requested to detect displaced meniscal tears because they often require often surgery. 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. Delayed, gadoliniumenhanced mri of cartilage dgemric is useful for assessing cartilage health. Robert laprade details the specifics on how to read an mri of a medial meniscus tear. All patients attending our clinic with knee pain from january 2003 to december 2004 underwent systematic and thorough clinical assessment. With a sensitivity of 95% and a specificity of 81% for medial meniscal tears and sensitivity of 85% and a specificity of 93% for lateral meniscal tears 2,5, mri is the modality of choice when a meniscal tear is suspected, with sagittal images being the most sensitive 5.
The medial meniscus is injured much more often than the lateral menis cus, with the posterior horn being the most afflicted component. Rehabilitation exercises a meniscus tear is a common knee joint injury. Meniscus tear treatment without surgery with 3 exercises see more. Symptomatic, radiographically confirmed osteoarthritis of the knee affects more than 9 million people in the united states. Magnetic resonance imaging mri is a test that provides pictures of organs, bones, and joints. Each type of meniscal tear has its own characteristics on mri, but in most cases, the following can be seen 3.
The meniscus is the primary shock absorber in our knee. Mri of the knee for meniscal and anterior cruciate. Detached meniscal tissue is referred to as a free meniscal fragment. One hundred and fifty patients were clinically diagnosed to have meniscal tears. When people talk about torn cartilage in the knee, they are usually referring to a torn meniscus. It makes these images by using a magnetic field and pulses of radio wave energy. He or she will want to hear details about how you got your injury. Magnetic resonance imaging mri has now an indisputable role for the diagnosis of meniscus and ligament injuries of the knee. A tear of a meniscus is a rupturing of one or more of the fibrocartilage strips in the knee called menisci. Meniscal tears can occur when the knee is forcefully twisted, sustains a direct blow, deep squatting or during activities that require changing directions. All anatomical descriptions were clearly illustrated by mri, arthroscopy, andor drawings. Management of degenerative meniscal tears and the role of. The meniscus is a cshaped fibrocartilaginous structure in the knee incompletely covering the surface of the tibia where it articulates with the femur. This tear begins at the free edge of the meniscus and extends towards the.
Any information contained in this pdf file is automatically generated from digital. There are different types of meniscus tears and a horizontal cleavage tear occurs within the fibers of the meniscus and splits the meniscus in the top and bottom pieces. Mri has high sensitivity and specificity for diagnosing meniscal tears. There is a medial meniscus, on the inner part of the knee, and a lateral meniscus on the outer aspect of the knee. It is important to note that not all meniscal and acl tears require surgery. Meniscal tears can be assessed arthroscopically for stability and vascularity. It also helps stabilize your knee and keep it from wearing out at a young age. Mri demonstrating a tear of the posterior horn of the medial meniscus, represented by an area of. If you are young and athletic, this should be fixed with surgery.
Imaging of meniscus and ligament injuries of the knee. Meniscal tear injury cambridge uk knee joint injury. Nov 01, 2018 sagittal mri of the knee in a 44 year old male following a twisting injury reveals hyperintense bright signal in keeping with fluid, extending to the undersurface of the posterior horn of the medial meniscus, in keeping with a tear. An mri will be able to take pictures of cartilage and ligaments to determine if theres a meniscus tear. After suffering a meniscus tear, your physician will usually order knee xrays to make sure there is no damage to your bones. In older athletes, many meniscal tears are the result of trivial trauma, like. The subsequent medial meniscus tear rate requiring removal was 16% in the study group versus 6% in the control group. You may also need an mri magnetic resonance imaging scan, which allows a more detailed evaluation of knee cartilage. A subset of 109 patients from the above group who sequentially had clinical examination, mri and arthroscopy for. Sports knee injuries assessment and management orthosports. Meniscal pathology and therapy are depicted in detail, followed by the presentation of longterm experience of meniscal transplantation and a look into the future of meniscal surgery. How well the knee will heal and whether surgery will be needed depends in large part on the type of tear see figure in appendix and how bad the tear is. This is important as the knee joint is used in most activities. Athletes, particularly those who play contact sports, are at risk for meniscus tears.
Apr 22, 2006 this retrospective study was conducted to analyse the reliability of clinical diagnosis in meniscal tear injuries. The goal of this article is to summarize the literature about the diagnosis of meniscal tears on mri including the normal appearance of the meniscus and the appearance of the various types of meniscal tears. Meniscus tears will not show up on xrays so your physician may also order a mri of the knee. New way to evaluate meniscus tear outcomes researchers. As we age, this cartilage begins to lose elasticity and can easily be torn without any type of trauma.
Pdf we investigated 3 knees with suspected meniscal or cruciate injuries by magnetic resonance. Las vegas, nv an individuals meniscus cushion in the knee is one of the most important ligaments in the leg providing stability, load bearing and preservation of the knee joint. Can you read your own knee mri for a meniscus tear. Computed tomography scan ct scan computed tomography scan ct or cat scan is a noninvasive diagnostic imaging procedure that uses a combination of special xray equipment and sophisticated computer technology to produce crosssectional images often called slices, both horizontally and vertically, of the body. Mri of the knee a guide to evaluation and reporting. Disc like configuration commonly affects lateral meniscus imaging. The mr images are uptodate, well labeled, and pertinent to todays imaging practice. Arthroscopic meniscal repair has become the treatment of choice when the tear is located in the peripheral rim. The sensitivity for diagnosing a meniscal tear was significantly higher when the tear involved more than onethird of the meniscus or the anterior horn.
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