MRI grading system for abnormal meniscal signal intensity

Last revised by Dr Henry Knipe on 27 Apr 2022

MRI grading system for abnormal high meniscal signal intensity was reported by Lotysch et al.  

Classification

Grade 1 to 3 have been described on MRI:

  • grade 1: small focal area of hyperintensity, no extension to the articular surface
  • grade 2: linear areas of hyperintensity, no extension to the articular surface
    • 2a: linear abnormal hyperintensity with no extension to the articular surface
    • 2b: abnormal hyperintensity reaches the articular surface on a single image
    • 2c: globular wedge-shaped abnormal hyperintensity with no extension to the articular surface
  • grade 3: abnormal hyperintensity extends to at least one articular surface (superior or inferior), and is referred to as a definite meniscal tear

Grade 2 meniscal signal was found to be associated with a meniscal tear on arthroscopy. Therefore, grade 2 was further subdivided into 2a, 2b, and 2c. Dillon et al. found that 50% of patients with grade 2c had meniscal tears on arthroscopy.

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Cases and figures

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