Dr. Sereni returns to continue his discussion on meniscal injuries. In this podcast Dr. Sereni discusses the evolution of previously discussed basic tears into complex and displaced tears.

Guest: Christopher Sereni, MD. Assistant Professor of Radiology, Division of Musculoskeletal Imaging & Intervention, UMMS Dept of Radiology.

Host: Christopher Cerniglia, DO, ME, FAOCR. Associate Professor of Radiology, Division of Musculoskeletal Imaging & Intervention, UMMS Dept of Radiology.

Review

•Abnormal signal or abnormal morphology

•Three basic types of tears

-Longitudinal vertical (aka the can-opener)

-Horizontal (pita bread)

-Radial (pizza slicer)

-Complex tear - nonstandard combination of basic tear types

Tears in the setting of an ACL injury - a frequently overlooked setting

•Mensicocapsular separation

•Wrisberg rip

-ACL tear allows tibia to translate anteriorly

-Ligament of Wrisberg causes traction on posterior horn of the lateral meniscus, causing vertical longitudinal tear

Displaced tears

•Longitudinal vertical --> bucket handle tear

-central migration of inner portion with or without flipping

-signs - not the be-all end-all

-fragment in the notch

-double anterior horn

-double PCL

-Small posterior horn/body

•Horizontal tear --> flap tear

-inferior flap tear could potentially go unnoticed on arthroscopy

-boomerang sign

-common displaced tear

•Radial oblique tear --> Parrot beak tear

-Displaced flap

-Parrot beak appearance on axial sequence

Resources:

• Saad SS, Gorbachova T, Saing M (2015) Meniscal tears: scanned, scoped, and sculpted. Radiographics 35(4):1138–1139

• De Smet AA. How I diagnose meniscal tears on knee MRI. AJR Am J Roentgenol 2012;199(3):481–499.