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Inferomedial displacement of the meniscal free fragment: MR findings
Fortunato Sorrentino1, Angelo Iovane, Antonio Nicosia
1DIBIMEL, Sezione di Scienze Radiologiche, Università degli Studi di Palermo, Palermo, Italy. drdiving@yahoo.it
Purpose:
To define the accuracy of Magnetic Resonance (MR) in the diagnosis of inferomedial displacement of the meniscal fragment.
Materials And Methods:
The MR examinations of the knee performed between December 2002 and April 2004 on 676 patients (mean age 32 years) with knee trauma and subsequently subjected to arthroscopy were retrospectively reviewed to assess the presence of bucket-handle meniscal tear and inferomedial displacement of the meniscal free fragment. The MR examinations were performed using a superconductive 0.5 T MR unit with a transmitting/receiving coil dedicated for the extremities. The MR images were acquired with SE T1 and GE T2* sequences in the sagittal, coronal and axial planes with 3 mm thickness and 1 mm gap. The images were independently reviewed by two authors blinded to the arthroscopic findings. In case of disagreement, a third author, unaware of the arthroscopic findings, gave his judgment.
Results:
On MR images a bucket-handle meniscal tear was identified in 54/676 patients. In 6 out of 54 patients, an inferomedial meniscal fragment displacement of the medial meniscus with associated inflammatory synovial reaction around the fragment was detected. In one case an associated inflammatory bursal reaction with effusion around the distal insertion of the medial homolateral collateral ligament was detected. All cases were confirmed by arthroscopy and no statistical differences between the two authors were observed.
Conclusions:
MR allows the detection of the inferomedial meniscal fragment displacement and a more correct planning of arthroscopy with a strong reduction of repeat interventions.
Insights
Magnetic Resonance (MR) accurately detects inferomedial meniscal fragment displacement, aiding in surgical planning and reducing repeat arthroscopy procedures for knee injuries.
Area of Science:
- Orthopedic imaging
- Knee joint pathology
Background:
- Bucket-handle meniscal tears are common knee injuries.
- Inferomedial displacement of meniscal fragments can complicate diagnosis and treatment.
Purpose of the Study:
- To evaluate the diagnostic accuracy of Magnetic Resonance (MR) imaging for inferomedial displacement of meniscal fragments.
- To assess the utility of MR in planning arthroscopic surgery for meniscal tears.
Main Methods:
- Retrospective review of 676 knee MR examinations in patients with trauma, compared with arthroscopy.
- MR imaging utilized a 0.5 T unit with SE T1 and GE T2* sequences in multiple planes.
- Independent review by blinded radiologists, with adjudication by a third radiologist for discrepancies.
Main Results:
- Bucket-handle meniscal tears identified in 54 patients (8%) on MR.
- Inferomedial displacement of the medial meniscus was detected in 6 of these patients (1.1% of total).
- Associated inflammatory reactions were noted in some cases, confirmed arthroscopically.
Conclusions:
- MR imaging is accurate for diagnosing inferomedial meniscal fragment displacement.
- Enhanced diagnostic capability of MR can lead to more precise arthroscopic planning.
- Utilizing MR may significantly decrease the need for revision arthroscopic procedures.
