Because a torn meniscus is made of cartilage, it wont show up on xrays. He or she will want to hear details about how you got your injury. Torn meniscus ppt free download as powerpoint presentation. A tear of a meniscus is a rupturing of one or more of the fibrocartilage strips in the knee called menisci. The meniscus is a type of cartilage in your knee joint. Learn what happens when you tear your meniscus and how these tears are treated. The long term protective effect of the menisci on the joint surfaces has been well documented. One of humanitys most common injuries during sports is an injury to the knee joint meniscus. Incidental meniscal findings on knee mri in middleaged and. This is important as the knee joint is used in most activities. Some technical advances have improved the diagnostic capabilities of mri so that diagnoses, which may change the therapeutic approach, such as a partial tear of the anterior cruciate ligament or confirmation of unstable meniscal injuries, are now made easier. If you have such an injury, you may feel knee pain and have limited motion. The simple and confusing types of meniscal tear in mri.
How to read an mri of a medial meniscus tear minnesota. Although it has shown excellent accuracy in diagnosing knee pathology, there remain many potential pitfalls and missed lesions. In addition to the diagnostic arthroscopy, mri is considered to be the gold standard of diagnosis of a meniscal root tear. There were 78 knees 70 patients in nondlm group and 78. You may also need an mri magnetic resonance imaging scan, which allows a more detailed evaluation of knee cartilage. This study calculates the sensitivity, specificity, and accuracy of mri in determining the presence or absence of discoid lateral meniscus dlm for different tear types. They often tend to be radial tears extending into the meniscal root. Artificial intelligence to diagnose meniscus tears on mri. All anatomical descriptions were clearly illustrated by mri, arthroscopy, andor.
In the two most recent series, meniscus mri and mri of the supporting structures, we focus on two important areas of assessment. Image processing in detection of knee joints injuries. Robert laprade details the specifics on how to read knee mri of medial meniscus tear. Risk factors for medial meniscal pathology on knee mri in. Its the best imaging study to detect a torn meniscus. Meniscus tears are among the most common knee injuries. Each type of meniscal tear has its own characteristics on mri, but in most cases, the following can be seen 3. The algorithm was tested on a number of images of the knee obtained with a use of the magnetic resonance imaging technique mr.
Rehabilitation is suggested as the primary treatment option for young adults following an acute acl tear. Optimizing recovery after knee meniscal or cartilage. If your symptoms are moderate to severe, or if your doctor thinks you have a meniscus tear and other knee injuries, he or she may recommend either an mri or arthroscopy. Sep 11, 2017 mri evaluation of torn lateral meniscus was compared with arthroscopy. Pdf medial and lateral knee joint menisci serve to transfer load and absorb shock, aid joint stability and provide lubrication. To study mr findings of meniscal tears with discoid lateral menisci dlms and to evaluate the incidence and accuracy of mri compared to arthroscopical surgery. Meniscal root tears are a type of meniscal tear in the knee where the tear extends to either the anterior or posterior meniscal root attachment to the central tibial plateau. Even partial meniscectomy may lead to osteoarthritis. The meniscus tear is one of the most frequent cartilage injuries of the knee, and mri is a useful method for detecting meniscus tears as it has high sensitivity and specificity for that task.
Different patterns of meniscal tears are described radiologically and arthroscopically, however displacement of the torn part of the meniscus can cause characteristic appearance on mri. Spatial resolution can be improved by maximizing the matrix size while maintaining a small field of view and thin section thickness. Meniscal tear presentation, diagnosis and management racgp. This study investigates potential risk factors for medial meniscal lesions or extrusion in middleaged and elderly persons. Knowledge of meniscal pathology and mri appearances of degenerative and traumatic meniscal lesions has. While mris can help your doctor make a diagnosis, they arent considered 100 percent.
Radial linear defect in the axial plane, vertical linear defect truncation sign in the coronal plane, and the socalled ghost. Human sectional anatomy atlas of body sections ct and mri. Com meniscal cartilage tear top view femur thighbone tibia shinbone medical meniscus front view of knee lateral meniscus torn what are the symptoms. Ultimately, the increased contact pressure in the weight bearing portion leads to accelerated joint degeneration5,6,7. When there is an acl tear, particular attention should be paid on mri to the lateral meniscus because in one study lateral meniscal root tears were found in 8% of patients with acl tears but in only 0.
The exact role that the meniscus cartilages play in the function of the knee is poorly understood, but they do not act as a cushion between the femur and tibia, as many of us were taught see sidebar. M a reicher, s hartzman, g r duckwiler, l w bassett. How well the knee will heal and whether surgery will be needed depends in large part on the type of tear see figure in appendix and how bad the tear is. Bucket handle medial meniscus tear radiology case medial meniscus tear. Meniscal function is essential to normal function of the knee joint when the menisci is removed the joint contact area is reduced by 40% the contact area is 2. The knee practical office orthopedics accessmedicine. The purpose of this study was to build and evaluate a highperformance algorithm to detect and characterize the presence of a meniscus tear on mri of.
The most widely accepted theory describes meniscal cysts resulting from extrusion of synovial fluid through a peripherally extended horizontal meniscal tear, accumulating outside the joint capsule. Arthroscopic meniscal repair has become the treatment of choice when the tear is located in the peripheral rim. As we age, this cartilage begins to lose elasticity and can easily be torn without any type of trauma. Chris centeno goes over what to look for on your mri and the different types of meniscus tears. Mri appearance of the different meniscal ramp lesion types. Meniscal tears can be assessed arthroscopically for stability and vascularity. When a radial tear is present in the posterior root of the lateral meniscus, the appearance may be the same. But xrays can help rule out other problems with the knee that cause similar symptoms. Mar 22, 2017 in the two most recent series, meniscus mri and mri of the supporting structures, we focus on two important areas of assessment. We describe focal abnormal signal of the meniscus in the knees of six patients who had a history of acute trauma to the knee. All anatomical descriptions were clearly illustrated by mri, arthroscopy, andor drawings. Mr imaging of meniscal tears with discoid lateral meniscus. In an arthroscopic series of 1086 medial meniscal tears, the posterior horn was involved in 98% of the torn medial menisci.
Meniscus tear article about meniscus tear by the free. Tears are typically vertical in young patients and horizontal in the elderlyfigure 5. Menisci can be torn during innocuous activities such as walking or squatting. There are different types of meniscus tears and a horizontal cleavage tear occurs within the fibers of the meniscus and splits the meniscus. The different types of meniscal tears visible in mri examination are shown. Knee mri stock photos download 367 royalty free photos. Mar 16, 2014 can you read your own knee mri for a meniscus tear. Ideal sources for wikipedia s health content are defined in the guideline wikipedia. Discoid lateral meniscus can be overlooked by magnetic.
Either isolated or accompanied with anterior cruciate ligament injury, meniscal tears can be a source of significant knee pain, locking and instability. Athletes, particularly those who play contact sports, are at risk for meniscus tears. The use of highspatialresolution mr imaging increases the ability to detect meniscal tears, particularly subtle nondisplaced tears. It also acts as a bumper and can help prevent abnormal motion in the knee especially if your ligaments are loose or injured. Mri of the knee for meniscal and anterior cruciate. Any information contained in this pdf file is automatically generated from digital.
Clinical examination, mri and arthroscopy in meniscal and. A tear can also develop slowly as the meniscus loses resiliency. Buckethandle tears are usually longitudinal tears of the menisci with an attached fragment displaced away from the meniscus. Now we are ready to add the meniscus cartilages, which sit like two rubbery, horseshoeshaped pads on the surface of the tibia. Mr imagingbased diagnosis and classification of meniscal. With a sensitivity of 95% and a specificity of 81% for medial meniscal tears and sensitivity of 85% and a specificity of 93% for lateral meniscal tears 2,5, mri is the modality of choice when a meniscal tear is suspected, with sagittal images being the most sensitive 5.
Download 1,451 meniscus stock photos for free or amazingly low rates. You may not need magnetic resonance imaging mri or arthroscopy. The use of knee arthroscopy to treat degenerative meniscal tears is well established worldwide. When surgery is indicated, minimally invasive arthroscopic techniques can adequately achieve this goal. It is important to know what the normal findings seen on an mri of a post operative repaired meniscus are, so as not to misinterpret these findings as abnormal or pathological. The increasingly used isakos arthroscopic meniscus tear classification system has been shown to. Imaging of meniscus and ligament injuries of the knee.
These can be secondary to inherent technical limitations or artifacts related to mr. Mri showed a complete discoid medial meniscus with a horizontal cleavage and flap tear in the middle third of the meniscus. Knowing the distribution of meniscal tears is helpful in assessing the menisci on mri. Management of degenerative meniscal tears and the role of. There are different types of meniscus tears and a horizontal cleavage tear occurs within the fibers of the meniscus and splits the meniscus in the top and bottom pieces. During the last few decades, as the management of meniscal trauma has evolved, and knowledge gained on meniscal function, the orthopaedic surgeon has attempted to preserve the meniscus whenever possible. A prospective study comparing the accuracy of the clinical diagnosis of meniscus tear with magnetic resonance imaging and its effect on clinical outcome. The opposite knee showed a discoid medial meniscus with a tear in the middle portion, but the patient had no complaints on his left knee and physical examination did not reveal any abnormalities. This signal abuts the articular surface of the meniscus on mr imaging but does not meet criteria for a meniscal tear or degeneration. Mr appearances of surgically proved torn discoid lateral menisci dlm were studied in 57 knees 40 patients. Behrens, md abstract meniscal injury is a common cause for presentation to the emergency department or primary care physicians office. The first method uses watershed with a threshold segmentation approach. Robert laprade details the specifics on how to read an mri of a medial meniscus tear.
Evaluation of traumatic knee joint injuries with mri. A meniscus tear is an injury to one of the bands of rubbery cartilage that act as shock absorbers for the knee. Magnetic resonance imaging of meniscal degeneration in asymptomatic knees. Meniscal preservation should be the goal of treatment. Diagnostic radiologymusculoskeletal imagingtraumameniscal. Mri is a highly sensitive means for the detection of meniscal cysts 19. Pdf magnetic resonance imaging is modality of choice for the noninvasive evaluation of meniscal tears. Magnetic resonance imaging assesment of lateral meniscus. Various etiologies have been proposed, including trauma,hemorrhage, chronic infection, and mucoid degeneration. On mri, meniscal tears are evident as a linear signal intensity that extends through the meniscal substance to a free edge17 figure 4.
Methods prospective cohort study using populationbased subjects from birmingham, alabama and iowa city, iowa, usa the. Rehabilitation exercises a meniscus tear is a common knee joint injury. The trip database provides clinical publications about. There are three basic mr characteristicscriteria of meniscal tears 5. Pain and swelling are the most common signs of an injury to your meniscus. The stone clinic is a sports medicine clinic in san francisco, california, offering orthopaedic surgery and medical care, physical therapy. In 1948 fairbank first reported the roentenographic changes after meniscectomy 2. When doctors and patients refer to torn cartilage in the knee, they actually may be referring to an injury to a meniscus at the top of one of the tibiae. They are heavily associated with anterior cruciate ligament injuries, and because of their potentially important biomechanical role in knee. Meniscus stock photos download 1,451 royalty free photos. Mr imaging of 156 knees with arthroscopically confirmed lateral meniscus tears was analysed.
Links to movies, ppt slideshows and any other multimedia files are not. To diagnose a meniscus tear, your doctor will give you a thorough exam. Mri has been found to be extremely useful in diagnosing displaced meniscal tears, particularly, the buckethandle tears. Magnetic resonance imaging mri is a good non invasive imaging modality for evaluation of meniscal healing. As a general rule, mri examination of the knee includes t1weighted or pd proton densityweighted sequences in the sagittal plane without fat. Meniscal cysts have been described in association with both medial and lateral meniscal tears. Three different direct mri signs for the diagnosis of a meniscus root tear have been described. Work with your doctor to plan a rehabilitation rehab program that helps you regain as much.
The meniscus sits between the cartilage surfaces of the bone to distribute weight and to improve the stability of the joint. Magnetic resonance imaging mri of the knee is often performed in patients who have knee symptoms of unclear cause. Because of this tear distribution, i am cautious in diagnosing a medial meniscal tear that does not involve the posterior horn. Radial tearthis tear extends from the periphery to the free edge of the meniscus. Imaging of meniscus and ligament injuries of the knee sciencedirect.
Mri has high sensitivity and specificity for diagnosing meniscal tears. Pdf isakos classification of meniscal tears illustration on 2d. Images of the knee were collected from healthy subjects. Patients with previous menisectomies, knee ligament repairs or reconstructions and knee arthroscopies were excluded from the study. Meniscal injuries can be the result of a forceful, twisting event in a young athletes knee or it can insid. This uses radio waves and a strong magnetic field to produce detailed images of both hard and soft tissues within your knee. The meniscus is a crescent shaped specialized cartilage that helps cushion the knee and distribute to forces of walking, running, etc. Meniscal ramp lesions have been defined as longitudinal vertical peripheral tears of the medial meniscus involving the posterior meniscocapsular ligament, meniscotibial ligament, andor the redred zone of the posterior horn. Any information contained in this pdf file is automatically generated from digital material submitted. A meniscus tear can occur when the knee is suddenly twisted while the foot is planted on the ground. This paper presents image processing methods for visualization and classification of medial meniscus tears.
Racgp meniscal tear presentation, diagnosis and management. This injury has been observed in various populations, and it could be due to traumatic out of which. Take home message meniscal tears are common in sports and nonsports related injuries. From the present study, it was noted that magnetic resonance imaging is most comprehensive, non invasive and safe modality in radiological evaluation of knee injury. Human sectional anatomy atlas of body sections ct and mri images pdf free download. Knee meniscus disorders involve the medial meniscus or lateral meniscus, two semicircular pads of cartilage in the knee between the joint surfaces of the femur and tibia femoral and tibial condyles. In this case, a portion may break off, leaving frayed edges. Mri is often requested to detect displaced meniscal tears because they often require often surgery. The purpose of this study is to investigate the factors that affect the severity of medial meniscus extrusion in medial meniscus posterior root tear on coronal plane magnetic resonance imaging mri, such as duration of disease, the degree of arthritis chondral wear, subchondral edema, osteophyte size, and kl grade, and mechanical alignment. An mri will be able to take pictures of cartilage and ligaments to determine if theres a meniscus tear. An injury to your knee meniscus or joint cartilage can happen when you move suddenly or repeatedly move the wrong way. Meniscus injury is one of the most common causes of consultations for knee disorders.
Objectives meniscal pathology in which the aetiology is often unclear is a frequent finding on knee mri. Correlation between meniscal extrusion and symptom. Sometimes, meniscus tears may not show up on an mri because they can closely resemble degenerative or agerelated changes. The goal of this article is to summarize the literature about the diagnosis of meniscal tears on mri including the normal appearance of the meniscus and the appearance of the various typ. Magnetic resonance imaging mri has now an indisputable role for the diagnosis of meniscus and ligament injuries of the knee.
Download 367 knee mri stock photos for free or amazingly low rates. Magnetic resonance imaging can also be effectively used. There is severe knee pathology due to ostheoarthrosis, lateral meniscus maceration and medial meniscus knee ligament tear, mri. Also subtle pathology can be overlooked, and anatomic. How to read knee mri of medial meniscus tear video. Meniscal tear meniscus injury meniscus injuries your knee has 2 menisci.
Sports injury medicine department 9250 sw hall blvd. Diagnosis and management of meniscal injury jacob babu, md, mha. Some doctors prefer to do arthroscopy instead of mri. Aug 29, 2014 the medial meniscus posterior root tear mmprt leads to loss of hoop tension and, thus, loss of load transmissibility of the meniscus, which results in a biomechanical condition much like total meniscectomy5. In 1948 fairbank first reported the roentenographic changes after meniscectomy. Arthroscopic surgery is the gold standard for diagnosing meniscal tears, 8 but the most frequently used advanced diagnostic tool is magnetic resonance imaging mri. Diagnostic radiologymusculoskeletal imagingtraumalateral. Normal findings in a postrepair meniscus on mri mra.
Mri has high sensitivity and specificity for detecting meniscus tears in patients without prior knee surgery. It is important to note that not all meniscal and acl tears require surgery. Arthroscopy can locate a meniscus tear and treat it at the same time. Magnetic resonance mr imaging is a commonly used tool when evaluating patients with acute knee injury or chronic knee pain. The fragment can displace into the intercondylar notch or flip anteriorly. Vertical longitudinal tearthis tear can also become a bucket handle tear if the medial fragment displaces. Division of sports medicine, department of orthopaedic surgery, north shore university hospital, and orthopaedic associates of manhasset, manhasset, new york abstract increasing emphasis on the comprehensive reconstruction of the knee and on restoration of knee function after. The value of standard radiography is extremely limited for the assessment of meniscal injuries but may be indicated to obtain a. When people talk about torn cartilage in the knee, they are usually referring to a torn meniscus. Powerpoint presentation about 5 minutes long on a surgery i witnessed. Meniscal tears can occur when the knee is forcefully twisted, sustains a direct blow, deep squatting or during activities that require changing directions. However, diagnostic performance is considerably lower in individuals following partial meniscectomy since the conventional criteria used to diagnose a meniscus tear cannot necessarily be applied to the postoperative meniscus 916.
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