Meniscal ossicle

Last revised by Dr Dai Roberts on 22 May 2020

Meniscal ossicles are uncommon, often incidental, findings on radiography and cross-sectional imaging of the knee.

Reported to have a prevalence of 0.15% in the general population 2.

The etiology of a meniscal ossicle has not been definitively established, and congenital, traumatic, and degenerative origins have been suggested. Its association with the posterior horn of the medial meniscus may favor a traumatic origin 1.

It consists of cancellous bone with a cartilage interface. There is no fibroblast proliferation or neovascularization 3

  • more often in the posterior horn of the medial meniscus
  • should have smooth margins, as opposed to a fracture fragment, and no donor site from the femur or tibia

The ossicle should follow bone marrow signal on all sequences:

  • T1: hyperintense
  • T2FS/STIR: hypointense

If symptomatic, conservative noninterventional therapy is tried first. If this fails, arthroscopic resection can be considered. Interventional therapy may also be considered if the ossicle is associated with other meniscal pathology.

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Cases and figures

  • Case 1
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  • Case 2
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  • Case 3
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