Congenital hypoplastic meniscus with tear

Case contributed by Shailaja Muniraj
Diagnosis certain

Presentation

Old trauma. Now unable to bend knee.

Patient Data

Age: 24 years
Gender: Male

The anterior/posterior horn and its root attachment appears to be diminutive. Anterior horn measures 2.6 mm and the posterior horn 3.4 mm.

The posterior horn of medial meniscus shows oblique hyperintensity, with outer articular surface communication, suggestive of complete tear.

The anterior horn of lateral meniscus shows vertical hyperintensity, with superior and inferior articular surface communication, suggestive of a complete tear.

There is non visualization of the anterior cruciate ligament with mild anterior tibial translation, in keeping with chronic total tear.

There is intrasubstance hyperintensity of the femoral fibers of posterior cruciate ligament with no obvious fiber disruption, in keeping with low grade strain. Attachments are intact.

Small volume joint effusion seen.

No acute bony bruise identified.

Mild periarticular soft tissue thickening noted.

Special thanks : Dr H K Anand

Case Discussion

This case demonstrates:

1. dimunitive medial meniscus with partial tear in its posterior horn. Since the entire medial meniscus with root attachment appears to be uniformly diminutive, it most likely favors congenital hypoplasia.

2. complete tear of anterior horn of lateral meniscus.

3. complete chronic anterior cruciate ligament tear.

4. low grade posterior cruciate ligament strain.

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