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.