Related Experiment Video
Updated: Sep 4, 2026
Destabilization of the Medial Meniscus and Cartilage Scratch Murine Model of Accelerated Osteoarthritis
Published on: July 6, 2022
MRI of meniscal bucket-handle tears
1Department of Radiology, Menorah Medical Center, Overland Park, KS 66209, USA.
Objective:
A meniscal bucket-handle tear is a tear with an attached fragment displaced from the meniscus of the knee joint. Low sensitivity of MRI for detection of bucket-handle tears (64% as compared with arthroscopy) has been reported previously. We report increased sensitivity for detecting bucket-handle tears with the use of coronal short tau inversion recovery (STIR) images.
Design And Patients:
Three hundred and twenty-seven patients who had MRI of the knee between October 1994 and December 1996 and subsequently underwent arthroscopy were included in the study. We prospectively and retrospectively reviewed the MR examinations of the 30 patients with arthroscopically proven bucket-handle tears. Each of two observers examined each scan for the three traditional findings of bucket-handle tears: a double posterior cruciate ligament sign, a flipped meniscus sign and/or a fragment in the intercondylar notch. We also assessed STIR images in the coronal plane through the menisci looking for an area of increased signal within either meniscus with a displaced meniscal fragment.
Results:
By using four criteria for diagnosis of meniscal bucket-handle tears, our overall sensitivity compared with arthroscopy was 93% (28 of 30 meniscal bucket-handle tears seen at arthroscopy were detected by MRI). The meniscal fragment was well visualized in all 28 cases on coronal STIR images. The double posterior cruciate ligament sign was seen in 8 of 30 cases, the flipped meniscus was seen in 10 of 30 cases and a fragment in the intercondylar notch was seen in 18 of 30 cases.
Conclusion:
By using four criteria for diagnosis of bucket-handle tears, overall diagnostic sensitivity of MRI compared with arthroscopy increased from the previously reported 64% to 93%. Coronal STIR images are useful for detecting small meniscal bucket-handle tears.
Insights
Magnetic Resonance Imaging (MRI) can now detect bucket-handle tears of the meniscus with 93% accuracy using coronal short tau inversion recovery (STIR) images. This improved sensitivity aids in diagnosing these knee joint injuries more effectively.
Area of Science:
- Orthopedics
- Radiology
- Medical Imaging
Background:
- Meniscal bucket-handle tears involve displaced fragments of the knee meniscus.
- Previous MRI sensitivity for detecting these tears was limited (64% compared to arthroscopy).
Purpose of the Study:
- To evaluate the diagnostic sensitivity of MRI, specifically coronal short tau inversion recovery (STIR) images, for detecting meniscal bucket-handle tears.
- To compare MRI findings with arthroscopic results in patients with suspected bucket-handle tears.
Main Methods:
- Retrospective and prospective review of 327 knee MRIs from October 1994 to December 1996.
- Focus on 30 patients with arthroscopically confirmed bucket-handle tears.
- Analysis of traditional MRI signs (double PCL sign, flipped meniscus, intercondylar fragment) and coronal STIR images for increased signal and displaced fragments.
Main Results:
- Overall MRI sensitivity for bucket-handle tears increased to 93% (28/30 cases) compared to arthroscopy.
- Coronal STIR images clearly visualized meniscal fragments in all 28 detected cases.
- Traditional signs had lower detection rates: double PCL sign (8/30), flipped meniscus (10/30), intercondylar fragment (18/30).
Conclusions:
- The combined use of four diagnostic criteria, including coronal STIR imaging, significantly enhances MRI sensitivity for bucket-handle tears to 93%.
- Coronal STIR sequences are valuable for identifying even small meniscal bucket-handle tears.
Related Concept Videos
01:24Magnetic Resonance Imaging
01:21Imaging Studies for Cardiovascular System IV: CMRI
01:27Imaging Studies IV: Magnetic Resonance Imaging