anterior horn lateral meniscus tear: mri

The self-reported complication rate for partial meniscectomy is 2.8% and meniscus repair is 7.6%. 1). 3. The articular cartilage is well seen on the pre-operative sagittal proton density-weighted image (19B). However, the tear changes plane of orientation over its course. for the ratio of the sum of the width of the anterior and posterior The location of meniscal tears or signal alterations (anterior/posterior horn or body of the medial/lateral meniscus) and the grade (normal/intra-substance signal abnormality = 0 and tear = 1) were determined on 2D . attachment of the posterior horn is the Wrisberg meniscofemoral Dr. Michael Gabor answered Diagnostic Radiology 35 years experience No,: It doesn't sound like a bucket handle tear CT arthrography is recommended for patients with MRI contraindications or when extensive susceptibility artifact from hardware obscures the meniscus. Collagen fibers are arranged for transferring compressive loads into circumferential hoop stresses, secured by radially oriented tie fibers. typically into the anterior cruciate ligament. Shepard et al have done a nice job of telling us just how frequently this mistake can be made by fellowship trained musculoskeletal radiologists. Nakajima T, Nabeshima Y, Fujii H, et al. The medial meniscus is asymmetrical with a larger posterior horn. Synopsis: In a consecutive series of nearly 1000 knee MRIs, there was a 74% false-positive rate for the diagnosis of anterior horn meniscal tears. MR imaging evaluation of the postoperative knee. Lateral meniscus bucket handle tears can produce the double anterior horn sign or double ACL sign. Discoid lateral meniscus. 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. Type 1: A complete slab of meniscal tissue with complete tibial coverage. On examination, there was marked medial joint line tenderness and a large effusion. Radial tears comprise approximately 15 % of tears in some surgical series [. Criteria for a recurrent tear after greater than 25% meniscectomy Definite surfacing T2 fluid signal (or high T1 signal isointense to intra-articular gadolinium on MR arthrography) on 2 or more images or displaced meniscal fragment.17 Definite surfacing fluid signal on only one image represents a possible tear. American Board of Orthopaedic Surgery Practice of the Orthopaedic Surgeon: Part-II, certification examination case mix. trauma; however, other symptoms include clicking, snapping, and locking Tears in the red zone have the potential to heal and are more amenable to repair. However, this conjecture and others pre- highest.13,27,34,42 Tear locations, such as the posterior sented in literature are mostly speculative. joint: Morphologic changes and their potential role in childhood MRI features are consistent with torn lateral meniscus with flipped anterior horn superomedial and posterior, resting superior to the posterior horn. The common insertion of the anterior cruciate ligament (ACL) and the AHLM root may provide a pathway for disease. Of the anterior horn tears read on MRI, 85% involved the lateral meniscus anterior horn and about one half were judged to extend into the middle or body of the same meniscus. meniscus are not uncommon; they include an anomalous insertion of the It splits into two bands at the PCL, named Humphry(anterior to the PCL) and Wrisberg (posterior to the PCL). An abnormal shape may indicate a meniscal tear or a partial meniscectomy. Sagittal T2-weighted image (10B) reveals no fluid at the repair site. 15 year old patient with prior extensive lateral partial meniscectomy was treated with lateral chondroplasty and lateral meniscal allograft transplant with continued pain and clicking 6 weeks post-operative. Monllau J, Gonzalez G, Puig L, Caceres E. Bilateral hypoplasia of the medial meniscus. 2059-2066, Kinsella S.D., and Carey J.L. The anterior meniscofemoral ligament (Humphrey ligament) attaches proximally on the medial femoral condyle, inferior to the PCL insertion. The medial meniscus is more firmly attached to the tibia and capsule than the lateral meniscus, presumably leading to the increased incidence of tears of the medial meniscus [ 8, 11, 12 ]. Bilateral hypoplasia of the medial meniscus has also been The Journal of bone and joint surgery American volume. Most patients are asymptomatic, but injury to the meniscus can ligament will help to exclude these conditions.5 In the first It is believed that discoid . In this case, the patient never obtained relief from the initial surgery, and the surgeon felt this was a residual tear (failed repair) rather than a recurrent tear. medial meniscus, discoid lateral meniscus, including the Wrisberg Sagittal PD (. Stay up to date with the latest in Practical Medical Imaging and Management with Applied Radiology. Repair devices including arrows, darts and sutures are used to approximate the torn edges of the meniscus. This injury is biomechanically comparable to a total meniscectomy, leading to compromised hoop stressesresulting in decreased tibiofemoral contact area and increased contact pressures in the involved compartment.These changes are detrimental to the articular cartilage and . 2008;191(1):81-5. Am J Sports Med 2017; 45:4249, ElAttar M, Dhollander A, Verdonk R, Almqvist KF, Verdonk P. Twenty six years of meniscal allograft transplantation: is it still experimental? Advantages include a less invasive method of introducing intraarticular contrast, the ability to identify areas of hyperemic synovitis or periarticular inflammation based on enhancement and administration can be performed by the technologist. Klingele KE, Kocher MS, Hresko MT, et al. Menisci are present in the knees and the show cupping of the medial tibial plateau, proximal medial tibial physis While this test will show a tear up to 90% of the time, it does not always. These are like large radial tears and can destabilize a large portion of the meniscus. 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. normal knee. Type In these cases, surfacing meniscal signal on low TE series may represent recurrent tear, granulation tissue or residual grade 2 degenerative signal that contacts the meniscal surface after debridement. Lateral meniscus posterior horn peripheral longitudinal tear managed by repair. Sagittal proton density-weighted image (10A) demonstrates increased signal extending to the articular surface consistent with granulation tissue. (as previously described), meniscal cyst,26 discoid lateral meniscus in the same knee (Figure 9),25 and pathologic medial patella plica.27. Radiographic knee dimensions in discoid lateral meniscus: Comparison with normal control. discoid meniscus, although discoid medial menisci can occur much less On MR arthrography, (12B), gadolinium extends through the repair site indicating a tear. published a case series of anterior horn tears of the lateral meniscus in 14 soccer players (mean age 20.2 years). They found that 76 (8%) of these indicated a tear of the anterior horn of either the medial or lateral meniscus. Br Med Bull. The most common trials, alternative billing arrangements or group and site discounts please call There The tear was treated by partial meniscectomy at second surgery. with mechanical features of clicking and locking. this may extend to to the mid body." is this a bucket tear? 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. 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. A meta-analysis of 44 trials. menisci (Figure 8). The LaPrade classification systemof meniscal root tears has become commonly used in arthroscopy, and there is evidence that this system can be to some extent translated to MRI assessment of these tears ref. 3 years later the sagittal proton density-weighted image (15B) shows a healed posterior horn (arrow) with a new flap tear in the medial meniscus anterior horn (arrowhead). gestation, about the time when the knee joint is fully formed.1 Throughout fetal development, they found that the size of the lateral meniscus is highly variable, unlike the medial meniscus. of the anterior horn of the medial meniscus, an inferior patella plica, pivoting). In Thompson WO, Thaete FL, Fu FH, Dye SF. Is sport activity possible after arthroscopic meniscal allograft transplantation? Longitudinal medial meniscus tear managed by repair (arrow). 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). Because this is a relatively new procedure, few studies have been dedicated to MRI evaluation of postoperative root repair. Increased intrameniscal signal is commonly seen in the transplanted allograft but does not correlate with clinical outcome. Volunteerism and Sports Medicine: Where do We Stand? medial meniscus, and not be confined to the ACL as seen in an ACL tear. Meniscal root tears are a form of radial tear that involves the central attachment of the meniscus (12a). Intact meniscal roots. The patient underwent meniscal repair but had recurrent pain prompting repeat MRI 8 months post-operative. Interested in Group Sales? Clark CR, Ogden JA. Sagittal T2-weighted (18B) and fat-suppressed sagittal proton density-weighted sagittal (18C) images demonstrate fluid-like signal in the posterior horn suggestive of a recurrent tear. in 19916. 2006; 88:660667, Boutin RD, Fritz RC, Marder RA. mesenchymal mass that differentiates into the tibia, femur, and Discoid medial meniscus. The sensitivity of mri in detecting meniscal tears is generally good, ranging from 70-98%, with specificity in the same range in many studies. Resnick D, Goergen TG, Kaye JJ, et al. He presented after a few months with symptoms of instability. At 1 year, 5 of 6 were completely asymptomatic with the remaining patient minimally painful with no suggestion of meniscal symptoms. It is possible that there could have been some tears missed at arthroscopy that were on the undersurface of the anterior horn, an area which is extremely difficultif not impossibleto visualize. Anatomic variability and increased signal change in this area are commonly mistaken for tears. Symptomatic anomalous insertion of the medial meniscus. De Smet A. posterior horn of the medial meniscus include a triangular hypointense Magnetic resonance imaging (MRI) of both knee joints showed an almost complete absence of the anterior and posterior horns of the medial meniscus, except for the peripheral portion, hypoplastic anterior horns and tears in the posterior horns of the lateral meniscus in both knees (Fig. Discoid lateral meniscus was originally believed to result from an The patient underwent partial medial meniscectomy and ACL reconstruction. On the sagittal fat-suppressed T2-weighted image (7B), fluid extends into the tear. The menisci are C-shaped fibrocartilaginous structures composed of radial and circumferential collagen fibers that have several roles, including joint stabilization, load distribution, articular cartilage protection and joint lubrication. Both horns of the medial meniscus are triangular with sharp points. If a meniscus tear shows up on a MRI, it is considered a Grade 3. Learn more. meniscal diameter. Congenital absence of the meniscus is extremely rare and has been documented in TAR syndrome and in isolated case reports.2,3 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. {"url":"/signup-modal-props.json?lang=us"}, Weerakkody Y, Baba Y, Knipe H, et al. On MR images of the knee it is sometimes impossible to determine with confidence if a focus of high signal in the meniscus is confined to the substance of the meniscus or if it extends to involve the surface. {"url":"/signup-modal-props.json?lang=us"}, El-Feky M, Flipped meniscus - anterior horn lateral meniscus. A Intensity of signal contacting meniscal surface in recurrent tears on MR arthrography compared with that of contrast material. Sagittal proton density (PD) images through normal medial (, The medial meniscus is larger, more oblong, and normally has a larger posterior horn than anterior horn in cross section. Medial meniscus posterior horn peripheral longitudinal tear (arrow) seen on the sagittal proton density-weighted image (15A) and managed by repair. 3: The Wrisberg variant, where the meniscus may have a normal Recent evidence suggests that decreased extrusion may correlate to better clinical outcomes.18. We look forward to having you as a long-term member of the Relias Arthroscopy for Medial Meniscus Tears The decision to repair or remove the torn portion is made at the time of surgery. 1427-143. This article focuses on Normal frequently. hypoplastic meniscus was not the cause of the patients pain, suggesting The sagittal proton density-weighted image (13A) demonstrates linear high signal extending to the femoral and tibial surfaces (arrow). Magnetic resonance imaging (MRI) is the most accurate imaging technique in the diagnosis of meniscal lesions and represents a standard tool in knee evaluation. Evaluation of postoperative menisci with MR arthrography and routine conventional MRI. 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. Mechanical rasping or trephination of the torn meniscus ends and parameniscal synovium is used to promote bleeding and vascular healing. It is usually seen near the lateral meniscus central attachment site. The ends of the anterior and posterior horns are firmly attached to the tibia at their roots. A 64-year-old female with no specific injury presented with knee pain, swelling, and locking that she first noticed after working out at the gym. A Study of Retrieved Allografts Used for ACL Surgery, Long-Term Results of Meniscus Allograft Transplantation with Concurrent ACL Reconstruction, Anterior Horn Meniscal Tears — Fact or Fiction, How Triathletes Can Use Cycling Cadence to Maximize Running Performance, Pharmacology Watch: HRT - Position Paper Places Benefits in Question, Clinical Briefs in Primary Care Supplement. in this case were attributed to an anterior cruciate ligament tear Because there is less pressure on the meniscus there, it is difficult to evaluate the anterior region of the meniscus. Most horizontal tears extend to the inferior articular surface. A 2003 systematic review of the literature, in which 29 publications met strict inclusion criteria, demonstrated pooled weighted sensitivity and specificity of 93.3 % and 88.4 % for the medial meniscus and 79.3 % and 95.7 % for the lateral meniscus, respectively [, Most meniscal tears are visible and best seen on sagittal images. The incidence was calculated based on arthroscopic findings, and the potential secondary signs of meniscal ramp tears were evaluated on MRI. To provide the highest quality clinical and technology services to customers and patients, in the spirit of continuous improvement and innovation. and ACL tears can be mistaken for AIMM, but carefully tracing the Schwenke M, Singh M, Chow B Anterior Cruciate Ligament and Meniscal Tears: A Multi-modality Review. (PubMed: 17114506), BakerJC, FriedmanMV, RubinDA (2018) Imaging the postoperative knee meniscus: an evidence-based review. The MRI showed complete ACL tear with displaced bucket handle medial meniscus tear. joint, and they also protect the hyaline cartilage. Copy. Am J Sports Med 2017; 45:884891, Zaffagnini S, Grassi A, Marcheggiani Muccioli GM, et al. 2a, 2b, 2c). are reported cases of complete absence of the medial meniscus as posterior horn usually measures 12 mm to 16 mm in the sagittal plane in There are The medial meniscus is more tightly anchored than the lateral meniscus, allowing for approximately 5mm of anterior-posterior translation. The example above demonstrates the importance of baseline MRI comparison when evaluating the postoperative meniscus. You can use Radiopaedia cases in a variety of ways to help you learn and teach. A tear was found and the repair was revised at second look arthroscopy. These findings are also frequently associated with genu The medial meniscus is more firmly attached to the tibia and capsule than the lateral meniscus, presumably leading to the increased incidence of tears of the medial meniscus [ 8, 11, 12 ]. View Mostafa El-Feky's current disclosures, see full revision history and disclosures, Flipped meniscus - anterior horn lateral meniscus, Disproportionate posterior horn sign (meniscal tear). Of these patients treated nonoperatively, 6 had a diagnosis of an isolated anterior horn tear on MRI. They are usually due to an acute injury [. It has been calculated that the lateral meniscus absorbs about 70% of the forces across the lateral compartment of the knee. The anomalous insertion It is often explained by fibers of the anterior cruciate ligament and the covering synovium . Thirty-one of these patients underwent subsequent arthroscopic evaluation to allow clinical correlation. The main functions In some patients, hyperintense signal may persist at the repair site on conventional MRI for several years and is thought to represent granulation tissue. 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. Radiology. 36 year old male with history of meniscus surgery 7 years ago. Because most meniscal tears are not isolated to the red zone, it is understandable that most meniscal surgeries are partial meniscectomies which aim to restore meniscus stability while preserving as much native meniscal tissue as possible, to decrease the risk of osteoarthritis. At the time the article was created Yuranga Weerakkody had no recorded disclosures. seen on standard 4- to 5-mm slices.21 The Wrisberg ligament may also be thick and high in patients with a complete discoid lateral meniscus.22 Other criteria used to diagnose lateral discoid meniscus include the following: In the The MRI also demonstrated moderate degenerative spurring at the lateral joint compartment, a large knee joint effusion with . By comparison, the complication rate for ACL reconstruction is 9% and PCL reconstruction is 20%.20 Potential complications associated with arthroscopic meniscal surgery include synovitis, arthrofibrosis, chondral damage, meniscal damage, MCL injury, nerve injury (saphenous, tibial, peroneal), vascular injury, deep venous thrombosis and infection.21 Progression of osteoarthritis and stress related bone changes are seen with increased frequency in the postoperative knee, particularly with larger partial meniscectomies. These include looking for a Radiographs may MRI of the knee is commonly indicated for evaluation of unresolved or recurrent knee pain following meniscal surgery. insertion of the medial meniscus (AIMM) has been described, and it is For root tears in general, sagittal imaging may demonstrate a meniscal ghost sign. Meniscus tears are either degenerative or acute. Irrespective of the repair approach or repair devices used, diagnostic criteria for a recurrent tear remains the same fluid signal or contrast extending into the meniscal substance. ligament, and the posterior horn may translate or rotate due to ligament and meniscal fascicles. MRI failed to detect anterior horn injury of lateral meniscus in six (16.7%) cases, all of which were longitudinal fissure in the red zone. Sagittal proton density-weighted image (5B) through the medial meniscus at age 17 reveals an incomplete tibial surface longitudinal tear (arrow) in a new location and orientation. ligaments and menisci causing severe knee dysplasia in TAR syndrome. A The meniscal body is firmly attached to the deep portion of the medial collateral ligament complex via the meniscotibial ligament. as at no time in development does the meniscus have a discoid Pullout fixation of posterior medial meniscus root tears: correlation between meniscus extrusion and midterm clinical results. Root tears are often large radial tears that extend through the entire AP width of the meniscus. Extension to the anterior cortex of . 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. Bilateral discoid medial menisci: Case report. In children, sometimes an increased signal is seen within meniscus due to increased vascularity, but usually the signal does not contact articular surface. Meniscal transplant is usually reserved for patients younger than 50 years who have normal axial alignment. Tachibana Y, Yamazaki Y, Ninomiya S. Discoid medial meniscus. Report Ideal for residents, practicing radiologists, and fellows alike, this updated reference offers easy-to-understand guidance on how to approach musculoskeletal MRI and recognize abnormalities. Studies on meniscus root tears have investigated the relationship of osteoarthritis and an anterior cruciate ligament tear. It affects 4% to 5% of the patient population,6-9 with a much higher incidence, up to 13%, in the Asian patient population.10 It is the most common meniscal variant in children.11 separate the cavity. MRI plays a critical role in influencing the treatment decision and enables information that would obviate unnecessary surgery including diagnostic arthroscopy. Conventional MRI imaging of the postop meniscus offers a noninvasive evaluation of the knee, but postoperative changes can mimic a recurrent or residual meniscus tear. Twenty-one had ACL tears; all those with an PHLM tear had an ACL tear. The example above illustrates marked degenerative changes caused by loss of meniscal function. 3 is least common. However, few studies have directly compared the medial and lateral root tears. A displaced longitudinal tear is a "bucket handle" tear. Atypically thick and high location 2002; 222:421429, Ciliz D, Ciliz A, Elverici E, Sakman B, Yuksel E, Akbulut O. Meniscal disorders: Normal, discoid, and cysts. Discoid meniscus in children: Magnetic resonance imaging characteristics. 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. Clin Orthop Relat Res 2012; 470: pp. sagittal magnetic resonance (MR) images. ADVERTISEMENT: Supporters see fewer/no ads. A Wrisberg type variant has not been documented in Meniscal root tear. 1991;7(3):297-300. during movement, and less commonly joint-line tenderness, reduced diminutive (1 mm) with no increased signal to suggest root attachment Arthroscopy revealed a horizontal tear of PHMM, and a partial medial meniscectomy was performed. MR imaging is useful for evaluation of many possible complications following meniscal surgery. MRI appearance of Wrisberg variant of discoid lateral meniscus. 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. Meniscal root tearsare a type of meniscal tearin the knee where the tear extends to either the anterior or posterior meniscal root attachment to the central tibial plateau. Disadvantages include patient discomfort, increased cost, physician time needed for the procedure and radiation exposure during fluoroscopy. The discoid lateral-meniscus syndrome. The most frequent symptom is pain that usually begins with a minor Otherwise, the increased vascularity in children has sometimes led to false-positive reading of a meniscus tear. No paralabral cyst. Weight-bearing knee X-rays showed a 50 % narrowing in the medial compartment. And, some tears do not fill with contrast during arthrography. The meniscus is two crescent-shaped, thick pieces of cartilage that sit in the knee between the tibia and the femur. The congenitally absent meniscus appears to influence the development The avulsed anterior horn of the lateral meniscus is flipped over and situated above the posterior horn. It is important to know the age of the patient when interpreting the MRI. Kaplan EB. Clinical imaging. an adult), and approximately twice the size of the anterior horn on St. Louis County's newspaper of politics and culture the rare ring-shaped meniscus, to the classification. Horizontal (degenerative) tears run relatively parallel the tibial plateau. An intact meniscal repair was confirmed at second look arthroscopy. Lateral meniscus tears of the posterior root are a common concomitant injury to anterior cruciate ligament (ACL) tears [6, 16, 20]. Methods Eighteen patients who had arthroscopically confirmed partial MMPRTs were included. Both ligaments attach distally to the posterior horn of the lateral meniscus and contribute to posterior drawer stability . Pathology - a tear that has developed gradually in the meniscus. Examination showed lateral joint line tenderness and a positive McMurray sign. Radial Tear of the Medial Meniscal Root: Reliability and Accuracy of MRI for Diagnosis. 6 months post-operative she had increased pain prompting follow-up MRI. The lateral meniscus is produced by the varus tension and tibial IR. One important reason for such discrepancies is a failure to understand the transverse geniculate ligament of the knee (TGL). (Tr. Lee S, Jee W, Kim J. Radial or oblique tear congurations close to or within the meniscus . MRI Knee - Sagittal PDFS - Displaced meniscus Part of a torn meniscus can be displaced into another part of the knee joint In this image the anterior part of the meniscus (the anterior horn) is correctly located The posterior horn is displaced such that it is located next to the anterior horn The correct position of the posterior horn is shown Sagittal proton density-weighted image (8A) through the medial meniscus demonstrates signal extending to the tibial surface (arrow). Their conclusion that one should not perform surgery unless clinical correlation exists with effusions, mechanical catching or locking, or the failure to respond to nonoperative measures I believe is a good recommendation that we can all follow. morphology. Am J Sports Med 2016; 44:625632, De Smet AA, Horak DM, Davis KW, Choi JJ. Normal course and intensity of both cruciate ligaments. On examination, the patient had medial joint line tenderness with positive McMurray test. Meniscal transplants can fail at the implantation site by avulsion, failure of bone plug incorporation or bone bridge fracture. Magnetic resonance imaging (MRI) and computed tomography (CT) arthrography are both well suited for evaluation of these lesions though somewhat limited by cost and access for MRI and by invasiveness for CT arthrography . 10 The patient had a recent new injury with increased pain. Knee Surg Sports Traumatol Arthrosc. 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. For information on new subscriptions, product Cho JM, Suh JS, Na JB, et al. 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. Root tears are associated with a high risk for osteoarthritis. Longitudinal (longitudinal, peripheral-vertical) tears run parallel to the circumference of the meniscus along its longitudinal axis, separating the meniscus into central and peripheral portions (Fig. The meniscus can separate from the joint capsule or tear through the allograft. Radiology. 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. This scan showed a radial MMT. High signal close to fluid intensity contacts the tibial surface on the sagittal T2-weighted image (11B) and is equivocal.

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