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A Useful MRI Classification for Symptomatic Discoid Lateral Meniscus.

Eui Yub Jung1, Seongmin Jeong1, Sun-Kyu Kim1

  • 1Department of Orthopedic Surgery, National Medical Center, Seoul, South Korea.

Knee Surgery & Related Research
|September 10, 2021
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Summary

Magnetic resonance imaging (MRI) signal change accurately predicts discoid lateral meniscus (DLM) tears. Subgroup analysis of DLM shape on MRI helps determine tear type and guide surgical procedures for better patient outcomes.

Keywords:
Discoid meniscusclassificationmagnetic resonance imagingmeniscal tear

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Area of Science:

  • Orthopedic Surgery
  • Radiology
  • Knee Meniscus Injuries

Background:

  • The discoid lateral meniscus (DLM) is a congenital anomaly that can lead to knee pain and meniscal tears.
  • Accurate diagnosis and classification of DLM tears are crucial for effective treatment planning.

Purpose of the Study:

  • To classify discoid lateral meniscus (DLM) based on magnetic resonance imaging (MRI) signal and shape.
  • To correlate MRI findings with arthroscopic tear types and surgical procedures.
  • To provide diagnostic and treatment guidance for DLM.

Main Methods:

  • Retrospective review of 162 patients with DLM diagnosed by MRI who underwent arthroscopy.
  • Three observers evaluated MRI findings using three criteria to predict arthroscopic tears.
  • Selected the most accurate criterion to classify tears and further subgrouped based on meniscal deformation or displacement.

Main Results:

  • Intra-meniscal signal change on MRI (criterion 3) demonstrated the highest agreement with arthroscopic tears.
  • No meniscal deformation/displacement (group 1a) correlated with non-specific tears and saucerization.
  • Meniscal deformation (group 1b) was associated with horizontal tears and saucerization.
  • Meniscal displacement (group 1c) indicated peripheral tears, repair, and subtotal meniscectomy.
  • Significant differences in tear types and procedures were observed across subgroups (P < .05).

Conclusions:

  • Intra-meniscal signal change on MRI is the most reliable indicator for predicting arthroscopic tears in symptomatic DLM.
  • Subgrouping DLM by deformation or displacement on MRI aids in predicting specific tear types and necessary surgical interventions.