How to Detect Meniscal Ramp Lesions Using Ultrasound

The clinical importance of meniscal ramp lesions in patients with anterior cruciate ligament tears has emerged. However, the diagnostic accuracy of magnetic resonance imaging for detecting meniscal ramp lesions is low. The advantage of ultrasonography is that it can be performed in any position and is a real-time imaging modality. The goal of this Technical Note is to describe in detail the ultrasound technique that we use to detect meniscal ramp lesions in patients with anterior cruciate ligament tears. The semimembranosus muscle is a reliable landmark for this technique. The examination position is prone, with the knee joint flexed to 70°. The most important part of this technique is to instruct the patient to perform isometric contractions in knee flexion with the support of an assistant. The presence or absence of a meniscal ramp lesion can be diagnosed preoperatively by setting the probe above the semimembranosus tendon.