Ramp lesion

Case contributed by Dr Utkarsh Kabra

Presentation

Twisting injury of knee

Patient Data

Age: 15 years
Gender: Male
MRI

Vertical longitudinal tear of peripheral aspects of posterior horn of the medial meniscus adjacent to meniscocapsular junction, reaching superior as well as inferior articular surfaces.

Bone contusion with marrow edema is seen in lateral tibial condyle. Mild marrow edema in both femoral condyles.

Near complete tear of anterior cruciate ligament is seen near its femoral attachment.

Posterior cruciate ligament is lax. Its continuity is maintained.

Mild edema superficial to medial collateral ligament. Its continuity is maintained.

Possible tear of anterior inferior popliteomeniscal fascicle.

Edema is seen in Hoffa's fat pad, along inferior patellar plica, possibly inferior
patellar plica injury.

Mild to moderate joint effusion extending into suprapatellar recess.

Case Discussion

Vertical longitudinal tear of peripheral aspects of posterior horn of medial meniscus adjacent to meniscocapsular junction, reaching superior as well as inferior articular surfaces. This is consistent with a Ramp lesion and is seen commonly in association with anterior cruciate ligament tears as in this case.

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