Learning objectives
1) Describe normal meniscal anatomy and surrounding relevant anatomic structures that are subject to pathology.
2)Review meniscal tears,
key anatomic variants and discuss pitfalls that radiologists should be aware of.
Background
Given the high incidence and burden of meniscal related knee pain,
it is crucial that radiologists give accurate and timely diagnosis of meniscal pathology on imaging.
This will aid clinicians in deciding whether conservative treatment or surgical exploration is needed.
Meniscal damage is directly linked with early degenerative osteoarthritis,
features of which are usually present on imaging.
Succinctly relaying these findings to the referrers,
especially to primary care practitioners who may not be familiar with certain terminology is as important as the diagnosis itself.
Whilst...
Imaging findings OR Procedure Details
Anatomy
Anatomically each meniscus is divided into 3 (thirds) longitudinal segments:
1) the anterior horn
2) body(middle third)
3) posterior horn
Each meniscus measures between 4–7 mm in height,
tapering to a thin,
sharp inner margin.
Due to their fibrocartilaginous content both the medial and lateral menisci classically demonstrate diffuse low SI on all MRI imaging sequences.
On the peripheral slice sagittal images the menisci demonstrate the classical bow-tie appearance which represents the body Fig. 2 .
The anterior and posterior horns are typically demonstrated...
Conclusion
By using the described teaching points and reviewing the relevant anatomy discussed in this pictorial review we hope to make radiologists aware of how to report and accurately describe meniscal tears.
Describing various tear patterns using accepted nomenclature is important in standardising reports and making sure referrers know the implications of these findings.
Awareness of the conventional anatomy,
common anatomic variants and indirect secondary signs of meniscal tears can be crucial in improving the accuracy for the reporting radiologist and aid the clinician in appropriate...
References
1)Nguyen JC,
De Smet AA,
Graf BK,
Rosas HG.
MR imaging-based diagnosis and classification of meniscal tears.
Radiographics.
2014;34(4):981-999.
doi: 10.1148/rg.344125202 [doi].
2)Saifuddin.A (et al) 2016,
Musculoskeletal MRI,
CRC Press
3)Arthur A.
De Smet,
How I Diagnose Meniscal Tears on Knee MRI AJR Am J Roentgenol.2012 Sep;199(3):481-99.
doi: 10.2214/AJR.12.8663.
4)Bolog NV,
Andreisek G.
Reporting knee meniscal tears: technical aspects,
typical pitfalls and how to avoid them.Insights Imaging.
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doi:10.1007/s13244-016-0472-y
5)Magee T,
Williams D.
Detection of meniscal tears and marrow lesions using coronal MRI.AJR Am J...