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Meniscal root tear

Dr Henry Knipe ◉ ◈ and Dr Yuranga Weerakkody ◉ et al.

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. They often tend to be radial tears extending into the root.

On this page:

Article:

Epidemiology
Pathology
Radiographic features
History and etymology
Related articles
References

Images:

Cases and figures

Epidemiology

According to one source, they are thought to account for ~10% of all arthroscopic meniscectomies ⁵.

Pathology

While they can arise from a number of mechanisms, root tears are generally thought to be chronic ⁵.

Associations

ACL tears are associated with posterior horn root tears of the lateral meniscus

Radiographic features

MRI

Best assessed on T2 weighted sequences. When it involves the posterior root, medial root tears are easier to diagnose than lateral root tears.

On medial posterior root tears there is often ²:

shortening or absence of the root on sagittal images
vertical fluid cleft on coronal fluid-sensitive (T2) images

On posterior root radial tears of the lateral meniscus, the appearance may be similar to radial tears in other locations.

For root tears in general, sagittal imaging may demonstrate a meniscal ghost sign.

Other features include:

truncation sign on coronal images⁴
features meniscal extrusion on coronal plane ⁴

History and etymology

They were first described by M J Pagnani et al. in 1991⁶.

Quiz questions

{"accessible":false,"alternatives":[{"id":5556,"text":"it gives a PPV of above 90% for medial meniscal tear but less than 60% for lateral meniscal tear "},{"id":5557,"text":"it applies to horizontal and vertical longitudinal tears but not to radial tears"},{"id":5558,"text":"it was validated on 1.5 T MRI but is also thought to apply to 3.0 T MRI"},{"id":5559,"text":"the signal abnormality must be seen on two contiguous slices in the same plane"},{"id":5560,"text":"the signal abnormality must extend to the meniscal periphery"}],"archived":false,"correctAlternativeId":5558,"explanation":"\u003cp\u003eThe \u003ca title=\"Two-slice-touch rule (knee MRI)\" class=\"internal\" href=\"/articles/two-slice-touch-rule-knee-mri\"\u003etwo-slice-touch rule\u003c/a\u003e is satisfied if intra-meniscal high signal extends to the meniscal superior articular surface, inner free edge or inferior articular surface on at least two MRI slices. These two slices may be contiguous in the same plane, but can also be in different planes at the same anatomical location (eg. single sagittal slice and single coronal slice). Signal contacting the meniscal periphery does not form any part of the rule. \u003c/p\u003e\u003cp\u003eIt applies equally to radial tears just as it does to horizontal tears and vertical longitudinal tears. Radial root tears can often be reliably diagnosed on a single slice, and therefore the rule is not always applied to this small subset of radial tears.\u003c/p\u003e\u003cp\u003eIt was initially validated for 1.5 T MRI but is also thought to apply to 3.0 T MRI. It has a high PPV for both medial and lateral meniscal tears. The reported PPV values vary between studies however the medial meniscus tear PPV is consistently above 90% and the lateral meniscus tear PPV is often just as high, and is certainly nowhere near as low as 60%. \u003c/p\u003e","id":1112,"imageUrl":null,"nextQuestionPath":"/questions/1112/next","relatedArticles":[{"id":39357,"title":"Longitudinal meniscal tear","link":"/articles/longitudinal-meniscal-tear?lang=us"},{"id":44003,"title":"Horizontal meniscal tear","link":"/articles/horizontal-meniscal-tear?lang=us"},{"id":41728,"title":"Radial meniscal tear","link":"/articles/radial-meniscal-tear?lang=us"},{"id":32949,"title":"Two-slice-touch rule (knee MRI)","link":"/articles/two-slice-touch-rule-knee-mri?lang=us"},{"id":32943,"title":"Meniscal tear","link":"/articles/meniscal-tear?lang=us"}],"stem":"\u003cp\u003eWhich is true regarding the \"two-slice-touch\" rule for meniscal tear diagnosis on MRI?\u003c/p\u003e","articleId":"meniscal-root-tear","nextQuestionId":null,"containerId":"expandableQuestionsContainer"}

References

Knee pathology

The knee is a complex synovial joint that can be affected by a range of pathologies:

bone and cartilage
ligaments
tendons
- patellar tendon rupture
- quadriceps tendon rupture
meniscal lesions
- meniscal tear
  - longitudinal tear
    - horizontal tear
    - longitudinal tear
      - Wrisberg rip
  - radial tear
  - root tear
  - displaced tear
  - signs
  - MRI grading system for meniscal signal intensity
- meniscal/parameniscal cyst
- meniscal flounce
- meniscal fraying
- meniscocapsular separation
- floating meniscus
bursosynovial lesions
fat pad
- fat pad impingement syndromes
  - Hoffa disease
- Hoffa fat pad herniation
popliteal fossa
fascia
- iliotibial band syndrome
alignment
- knee
- patella
  - patellar instability
  - patella alta
  - patella baja
  - indices
gamut

Article information

rID: 40036

System: Musculoskeletal, Trauma

Synonyms or Alternate Spellings:

Root tear of meniscus
Meniscal root tears
Root tears
Root tears of meniscus
Root tears of menisci
Root tears of the meniscus
Root tear of the meniscus

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Cases and figures

Case 1: green arrowCase 1: green arrow

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Case 2: red arrowCase 2: red arrow

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Case 3Case 3

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Case 4Case 4

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Case 5: posterior root medial meniscus Case 5: posterior root medial meniscus

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Case 6: root tear of medial meniscusCase 6: root tear of medial meniscus

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