[Buffalo Horn Sign - A New Finding on MRI for Meniscal Bucket-Handle Tears]

Area of Science:

• Orthopedic imaging
• Musculoskeletal radiology
• Knee joint pathology

Context:

• Bucket-handle meniscal tears are a common knee injury, often requiring surgical intervention.
• Accurate diagnosis and characterization of meniscal tears on magnetic resonance imaging (MRI) are essential for effective treatment planning.
• Existing MRI signs for bucket-handle tears may not always be definitive, necessitating the identification of new diagnostic markers.

Purpose:

• To describe a novel sign, termed the 'buffalo horn pattern', observed on axial MRI images.
• To evaluate the prevalence and diagnostic utility of the buffalo horn pattern in patients with bucket-handle meniscal tears.
• To assess the association of the buffalo horn pattern with other meniscal tear characteristics and anterior cruciate ligament (ACL) status.

Summary:

• A retrospective analysis of 28 patients with surgically confirmed bucket-handle meniscal tears identified the buffalo horn pattern in 46.4% of cases on axial MRI.
• The buffalo horn pattern was the third most common sign, following intercondylar notch fragments and the absent bow tie sign.
• This new sign demonstrated a significant association with other indicators of displaced meniscal tears and was not observed in healthy menisci or influenced by ACL tears.

Impact:

• The buffalo horn pattern is a valuable, easily identifiable sign for diagnosing displaced bucket-handle meniscal tears on axial MRI.
• Recognition of this sign can improve the accuracy of MRI interpretation, aiding in the determination of appropriate treatment strategies and surgical planning.
• This finding contributes to the radiologic characterization of meniscal tears, potentially enhancing diagnostic confidence and patient management.