Presentation
Lateral knee pain.
Patient Data
Complex tear of the central portion appearing displaced into the intercondylar area and a further displaced flap into the lateral meniscofemoral gutter with soft tissue edema. Posterior meniscofemoral ligament (of Wrisberg) and posterior meniscocapsular attachments are present.
Partial extrusion of the medial meniscus anterior body and anterior horn, however, no root tear.
High-grade chondromalacia change involving the patellar apex and central trochlear groove. High-grade chondral wear of the anteromedial tibial plateau.
Horizontal undersurface tear of the body and posterior horn lateral meniscus on a background of discoid morphology.
Moderate joint effusion. Focal chondrosis with marginal undisplaced chondral flap formation at the posterocentral weight-bearing surface of the medial femoral condyle. High-grade chondromalacia change involving the patellar apex and central trochlear groove.
Case Discussion
At first glance, this tear seems to be a bucket-handle tear although further interrogation of the tear shows that there are two regions of meniscal tissue in the central joint, and the more lateral of these two is in continuation with the anterior and posterior horns. Review of the prior MRI clearly shows a discoid meniscus. The morphology of the current tear is complex with the central portion torn and flipped both central and peripherally, a bit like a drum that has burst open centrally leaving a rim of tissue intact peripherally.