Meniscal tear
Updates to Article Attributes
Meniscal tears involve damage to the fibrocartilaginous menisci of the knee. They comprehend several types and can occur in an acute or chronic setting. Meniscal tears are best evalauted with MRI.
Clinical presentation
Acute meniscal tears occur after rotaryrotatory trauma of the knee. Chronic whereas chronic degenerative meniscal tears occur often inoccur in the elderly after minimal rotaryrotatory trauma or stress of theon the knee.
Types
There are different types of meniscal tears. Identifying and accurateaccurately describing the type of meniscal tear can help the surgeon in patient education and planning of the surgical procedure.
The differentMeniscal tear types areinclude 1:
- horizontal tear
- longitudinal tear
- radial tear
- root tear
- complex tear
- displaced tear
- bucket-handle tear
Radiographic features
Plain film
On plain radiographs the meniscal tear can meniscal tears are not be seenvisible. In rare cases secondary signs can be seen, such as a soft tissue swelling next to the meniscus when a meniscal cyst is present 4. Only when associated with more complex injuries, plain plain film may suggest thesea meniscal tear, e.g. arcuate sign, reverse Segond fracture, tibial plateau fracture.
MRI
With a sensitivity of 91% and a specificity of 81% for medial meniscal teartears 2 and a sensitivity of 76% and a specificity of 93% for lateral meniscal tear tears 2, MRI is the investigationmodality of choice when a meniscal tear is suspected. Each different type of meniscal tear has has its own characteristics on MRI, but in most cases the following can be seen 3:
-
T1: a
hyperintenshyperintense line in the meniscus can be seen, but it is difficult to differentiate between degeneration and meniscal tear on this sequence. In case of a bucket-handle tear an empty groove can sometimes be seen. -
T2 SPAIR:
hyperintenshyperintense line in the meniscus, which indicates synovial fluid in the meniscus.
Treatment and prognosis
Surgical arthroscopy is done in most of the cases. Meniscopexy or complete or partial meniscectomy can be performed, depending on the degree and type of meniscal tear.
-<h4>Clinical presentation</h4><p>Acute meniscal tears occur after rotary trauma of the knee. Chronic degenerative meniscal tears occur often in elderly after minimal rotary trauma or stress of the knee.</p><h5>Types</h5><p>There are different types of meniscal tears. Identifying and accurate describing the type of meniscal tear can help the surgeon in patient education and planning of the surgical procedure.</p><p>The different types are<sup>1</sup>:</p><ul>- +<p><strong>Meniscal tears </strong>involve damage to the fibrocartilaginous menisci of the knee. They comprehend several types and can occur in an acute or chronic setting. Meniscal tears are best evalauted with MRI.</p><h4>Clinical presentation</h4><p>Acute meniscal tears occur after rotatory trauma of the knee whereas chronic degenerative meniscal tears often occur in the elderly after minimal rotatory trauma or stress on the knee.</p><h5>Types</h5><p>There are different types of meniscal tears. Identifying and accurately describing the type of meniscal tear can help the surgeon in patient education and planning of the surgical procedure.</p><p>Meniscal tear types include <sup>1</sup>:</p><ul>
-</ul><h4>Radiographic features</h4><h5>Plain film</h5><p>On plain radiographs the meniscal tear can not be seen. In rare cases secondary signs can be seen, such as a soft tissue swelling next to the meniscus when a <a href="/articles/meniscal-cyst">meniscal cyst </a>is present <sup>4</sup>. Only when associated with more complex injuries, plain film may suggest these, e.g. <a title="Arcuate sign" href="/articles/arcuate-sign">arcuate sign</a>, <a title="Reverse Segond fracture" href="/articles/reverse-segond-fracture">reverse Segond</a> fracture, <a title="Tibial plateau fracture" href="/articles/tibial-plateau-fracture">tibial plateau</a> fracture. </p><h5>MRI</h5><p>With a sensitivity of 91% and a specificity of 81% for medial meniscal tear <sup>2</sup> and a sensitivity of 76% and a specificity of 93% for lateral meniscal tear <sup>2</sup>, MRI is the investigation of choice when a meniscal tear is suspected. Each different type of meniscal tear has its own characteristics on MRI, but in most cases the following can be seen <sup>3</sup>:</p><ul>- +</ul><h4>Radiographic features</h4><h5>Plain film</h5><p>On plain radiographs meniscal tears are not visible. In rare cases secondary signs can be seen, such as a soft tissue swelling next to the meniscus when a <a href="/articles/meniscal-cyst">meniscal cyst </a>is present <sup>4</sup>. Only when associated with more complex injuries plain film may suggest a meniscal tear, e.g. <a href="/articles/arcuate-sign">arcuate sign</a>, <a href="/articles/reverse-segond-fracture">reverse Segond</a><a href="/articles/reverse-segond-fracture"> fracture</a>, <a href="/articles/tibial-plateau-fracture">tibial plateau</a> fracture. </p><h5>MRI</h5><p>With a sensitivity of 91% and a specificity of 81% for medial meniscal tears <sup>2</sup> and a sensitivity of 76% and a specificity of 93% for lateral meniscal tears <sup>2</sup>, MRI is the modality of choice when a meniscal tear is suspected. Each type of meniscal tear has its own characteristics on MRI, but in most cases the following can be seen <sup>3</sup>:</p><ul>
-<strong>T1:</strong> a hyperintens line in the meniscus can be seen, but it is difficult to differentiate between degeneration and meniscal tear on this sequence. In case of a bucket-handle tear an empty groove can sometimes be seen.</li>- +<strong>T1:</strong> a hyperintense line in the meniscus can be seen, but it is difficult to differentiate between degeneration and meniscal tear on this sequence. In case of a bucket-handle tear an empty groove can sometimes be seen.</li>
-<strong>T2 SPAIR: </strong> hyperintens line in the meniscus, which indicates synovial fluid in the meniscus.</li>-</ul><h4>Treatment</h4><p>Surgical arthroscopy is done in most of the cases. Meniscopexy or complete or partial meniscectomy can be performed, depending on the degree and type of meniscal tear.<br> </p><h5> </h5>- +<strong>T2 SPAIR: </strong> hyperintense line in the meniscus, which indicates synovial fluid in the meniscus.</li>
- +</ul><h4>Treatment and prognosis</h4><p>Surgical arthroscopy is done in most of the cases. Meniscopexy or complete or partial meniscectomy can be performed, depending on the degree and type of meniscal tear.</p>
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