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Meniscal Duplication Sign ("Trowel sign"): A Novel Magnetic Resonance Imaging Indicator of Lateral Meniscus
Joseph Sajeev1, Anand Raj Rajendrababu1, Raphael Thomas1
1Department of Arthroscopy, St Johns Medical College, Bengaluru, Karnataka, India.
Introduction:
Bucket-handle tears of the lateral meniscus are commonly diagnosed using established magnetic resonance imaging (MRI) signs such as the double posterior cruciate ligament sign and absent bow tie sign. However, atypical presentations may pose diagnostic challenges.
Case Report:
We report a case of an 18-year-old male presenting with knee pain, instability, and locking following a twisting injury. T2-weighted MRI revealed two low-signal meniscus-like structures within the same sagittal slice, representing a displaced bucket-handle fragment adjacent to the native meniscus. This configuration, termed the Meniscal Duplication Sign, demonstrated a characteristic "Trowel appearance."
Conclusion:
The meniscal duplication sign is a novel MRI finding that may aid in identifying bucket-handle tears, especially when classical signs are absent.
