A 58-year-old man presented with knee pain and swelling, following a previous injury. A displaced bucket-handle tear of the medial meniscus was diagnosed on magnetic resonance (MR) imaging and subsequently confirmed by arthroscopy. MR imaging is accurate in diagnosing bucket-handle tears. The different MR imaging signs of bucket-handle tears include the double posterior cruciate ligament sign, displaced fragment in intercondylar notch sign, absent bow-tie sign, anterior flipped meniscus sign and coronal truncation sign. Specificity is increased when a combination of the different imaging signs is present. Understanding the meniscal anatomy and potential mimics of the bucket-handle tear is important in order to ensure an accurate diagnosis and appropriate management.
Humans ; Knee Injuries ; diagnosis ; Knee Joint ; pathology ; Magnetic Resonance Imaging ; Male ; Menisci, Tibial ; pathology ; Middle Aged ; Tibial Meniscus Injuries

PURPOSE: To compare MRI appearance between plicae syndrome and normal plicae. MATERIALS AND METHODS: MR images of 60 cases of arthroscopically-confirmed plicae syndrome and 18 of arthroscopically-proven normal plicae were retrospectively analyzed. Sagittal T2-weighted MR images in all cases and MPGR(200) in 37 cases of plicae syndrome were obtained. Statistical analysis was performed using the chi-square test. RESULTS: On the basis of operatingresults, we observed 55 medial plicae, eight combined medial and suprapatellar plicae, four suprapatellar plicae,and one lateral plica. T2-weighted sagittal MR scans of the 60 cases demonstrated 37 medial plicae, 8 suprapatellar and one lateral plica. Joint effusion was found in 26 cases of 55 medial plicae. In T2-weighted sagittal MR scans, the identification of medial plicae was superior in the presence of joint effusion than its absence(plicae syndrome, p < 0.001 ; normal plicae group, p < 0.05). Medial plicae were well demonstrated onMPGR(200) axial images; on T2-weighted sagittal MR scans, they could be more frequently identified in the plicae syndrome group than in the normal control group(p < 0.001). Plicae syndrome-associated pathology included degenerative change of the articular cartilage of the medial femoral condyle in eight cases(14.5%), discoidmeniscus in nine(16.4%), lateral meniscus tear in 12(21.8%), medial meniscus tear in 21(38.1%), anterior cruciate ligament tear in three(5.5%), medial collateral ligament tear and osteochondritis dissecans in one case. CONCLUSION: The present study revealed that synovial plicae were well demonstrated in T2-weighted sagittal images, particularly on the presence of joint effusion. Medial plicae could be more frequently identified in the plicae syndrome group than in the normal control group, especially on T2-weighted sagittal MR scans.
Cartilage, Articular ; Collateral Ligaments ; Humans ; Joints ; Magnetic Resonance Imaging ; Menisci, Tibial ; Osteochondritis Dissecans ; Pathology

The purpose of this study was to investigate the frequency of the meniscal flounce on MR imaging in patients who underwent arthroscopy or open surgery due to symptoms related to internal derangement of the knee, and to investigate associated findings in patients with meniscal flounce by comparing and analyzing the findings from MR imaging and surgery. MR images obtained from 116 knees before surgery were reviewed retrospectively. Seven medial menisci showed buckled, wavy flounce on sagittal MR images. None of the lateral menisci showed flounce. We reviewed the surgical records of all seven patients and the videotapes of six of the patients undergoing arthroscopy or open surgery. The frequency of flounce on sagittal MR images was 6.0% in the medial meniscus and was completely absent in the lateral meniscus. On coronal MR images, the truncated appearance of the affected meniscus was demonstrated in five patients, and a valgus deformity was seen in three patients. Five patients showed a moderate to large amount of joint effusion. On MR imaging and in surgery, ligament injuries were found in six patients (six medial collateral ligament injuries, five anterior cruciate ligament injuries, and two posterior cruciate ligament injuries). Non-specific synovitis was found in the one remaining patient. In the surgery of all seven patients, no tears were found at the meniscus itself showing flounce. In conclusion, the meniscal flounce seen on sagittal MR imaging can be a rare appearance of a transient distortion of a normal meniscus due to a valgus deformity caused by a MCL tear and/or due to an external rotation induced by cruciate ligament injury or positioning of knee joint within the magnet. The meniscal flounce should be interpreted carefully because it frequently appears truncated on the coronal scan and can simulate a meniscal tear.
Arthroscopy ; Human ; Knee Joint/surgery* ; Magnetic Resonance Imaging ; Menisci, Tibial/pathology*

From September 1983 to June 1988, the authors could experience 104 cases of meniscal injury from 99 patients by arthroscopic examination. The results of this study may be summarized as follows : 1. There were noticed 35 cases of medial meniscus tear, 35 cases of lateral discoid meniscus tear, 12 cases of intact lat discoid meniscus, 1 case of medial discoid meniscus and 3 cases of lateral meniscal cyst. 2. Most common type of meniscal tear was bucket handle type (35 cases, 34.6%). 3. Most common site of rupture was posterior horn of medial meniscus. 4. Post operative results appeared related with the type of meniscus rupture and combined pathology of knee jont. Bucket handle type rupture was of good prognosis and meniscus lesions with chondromalacia was of poor prognosis.
Animals ; Arthroscopy ; Cartilage Diseases ; Clinical Study ; Horns ; Humans ; Knee ; Menisci, Tibial ; Pathology ; Prognosis ; Rupture ; Tears

We reviewed the knee radiographs of 68 cases of arthroscopically-proven discoid lateral meniscus to evaluate usefulness of plain radiographs in diagnosing discoid lateral meniscus. The subject included 42 cases of complete type and 26 cases of incomplete type discoid lateral meniscus. Knee radiographs of 70 cases which had no pathology of the meniscus in knee arthroscopy were used as controls. We excluded patients who had a significant history of trauma and who were under 16 years of age or over 60 to avoid measuring radiographs of skeletally immature or degenerative knees. The absolute values and relative normalized values of specific knee dimensions such as a squared-off appearance of the lateral femoral condyle, widened femorotibial joint space, cupping of the lateral tibial plateau, obliquity of the lateral tibial plateau articular surface, high fibular head and hypoplasia of the Iateral intercondylar spine in discoid lateral meniscus and normal controls were compared. Among these dimensions, high fibular head and widened lateral tibiofemoral joint space showed statistically significant difference between the discoid lateral meniscus group and normal control group. We suggest that these findings could be useful in screening lateral discoid meniscus in plain radiographs.
Arthroscopy ; Head ; Humans ; Joints ; Knee* ; Mass Screening ; Menisci, Tibial* ; Pathology ; Spine

OBJECTIVE: To summarize the characteristics of clinic and pathology of the knee menisci injury with sclerosis denaturalization and to discuss the mechanism of the sclerosis and its clinic significance. METHODS: We retrospectively analyzed the diagnosis and treatment and healing of the knee menisci with the sclerosis denatured injury from 1989 to 2003. The changes of the partial meniscus with sclerosis denaturalization were observed in tissue section. RESULTS: Menisci with sclerosis denaturalization occupied 24.1%, and 77.6% of them subordinated to simple sclerosis denaturalization without tear. Their characteristics were that the manifestations were not except typical knee pain, tenderness at joint line,integrity shape with dull or less lubricity and tiny grand on the super face of menisci under the arthroscopy,and trembles could be touched by a probe. Pathology showed the formation of local sclerosis with the histological changes of fibro-hyperplasia, hyaline degeneration and mucous degeneration in the menisci. No operation obtained curative effects. Symptoms can be eliminated by the excision of the menisci with sclerosis denaturalization. CONCLUSION The clinic of simple meniscus injury with sclerosis denaturalization are non-typical and arthroscopic check-up is valuable for the diagnosis. The menisci can be removed from the patients suffered from heavy symptoms for a long time.
Adolescent ; Adult ; Aged ; Arthroscopy ; Child ; Female ; Humans ; Knee Injuries ; diagnosis ; pathology ; Male ; Menisci, Tibial ; pathology ; Middle Aged ; Retrospective Studies ; Sclerosis ; pathology ; Tibial Meniscus Injuries ; Wound Healing

The goal of the present study was to evaluate the diagnostic value of a joint distractor in arthroscopy in small-breed dogs. Sixty stifle joints, which were collected from thirty cadavers, were used in this study. To simulate different injuries, no medial meniscal tear, a full-thickness vertical longitudinal tear, a partial-thickness vertical longitudinal tear, full- and partial-thickness vertical longitudinal tears, or a peripheral detachment were created on the caudal horn of the medial meniscus of each stifle joint along with rupture of the cranial cruciate ligament. Each stifle joint then underwent arthroscopy with and without a joint distractor. The sensitivity (Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), and correct classification rate (CCR) for the diagnosis of each type of medial meniscus pathology were calculated. For arthroscopy with and without a joint distractor, the Sn was 85% and 60%, the Sp was 96% and 92%, the PPV was 85% and 65%, the NPV was 96% and 90%, and the CCR was 94% and 86%, respectively. Arthroscopy is an effective diagnostic method for the assessment of medial meniscal pathologies in small-breed dogs, especially when performed with the aid of a joint distractor.
Animals ; Anterior Cruciate Ligament ; Arthroscopy ; Cadaver ; Classification ; Diagnosis ; Dogs* ; Horns ; Joints* ; Menisci, Tibial ; Methods ; Pathology ; Rupture ; Sensitivity and Specificity ; Stifle ; Tears

Arthroscopy has become an attractive modality in the diagnosis and treatment of joint diseases in toy breed dogs. However, the application of arthroscopy is limited by small joint space. Our objective was to evaluate the efficacy of a stifle lever for joint distraction during stifle arthroscopy in toy breed dogs. Paired stifles (n = 32 each) collected from 16 cadavers of toy breed dogs were randomly assigned to one of two groups: the stifle lever group or the external manipulation group. All stifles underwent arthroscopic cranial cruciate ligament transection, and the visualization of the medial meniscus was evaluated. Medial meniscal release (MMR) was then performed. Following arthroscopic examination, the success rates of MMR and damages of tibial and femoral cartilages were evaluated. Visualization of the medial meniscus was significantly better, and meniscal probing was significantly easier, in the stifle lever group than in the external manipulation group (p = 0.001). There were no significant differences between groups for MMR success or articular cartilage damage. Using the stifle lever on arthroscopic examination improved visualization and probing on the medial meniscus in toy breed dogs. The stifle lever can be used as a good modality in assessing medial meniscal pathology in toy breed dogs.
Animals ; Anterior Cruciate Ligament ; Arthroscopy ; Cadaver ; Cartilage ; Cartilage, Articular ; Diagnosis ; Dogs ; Joint Diseases ; Joints ; Menisci, Tibial ; Pathology ; Play and Playthings ; Stifle

PURPOSE: The purpose of this study was to evaluate the efficacy of bone SPECT for the diagnosis of meniscal tear. MATERIALS AND METHODS: 63 cases that had undergone bone SPECT were evaluated for sensitivity and specificity by comparing arthroscopy and MRI findings. RESULTS: Bone SPECT showed a sensitivity of 93.8% and a specificty of 71% for medial meniscus and a sensitivity of 85.7% and a specificty of 87.8% for lateral meniscus tear. MRI was performed on 21 cases simultaneously, and agreement was obtained on the presence or absence, and on the nature of the pathology with bone SPECT in 15 cases (71.4%). CONCLUSION: Bone SPECT is believed to be an effective and economic way of screening for meniscal tear prior to arthroscopy, in suspected cases of meniscal tear.
Arthroscopy ; Diagnosis* ; Knee ; Magnetic Resonance Imaging ; Mass Screening ; Menisci, Tibial ; Pathology ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon*

Arthroscopy ; instrumentation ; Humans ; Knee Injuries ; diagnosis ; pathology ; Magnetic Resonance Imaging ; instrumentation ; Male ; Menisci, Tibial ; surgery ; Middle Aged ; Surgical Flaps ; Tibial Meniscus Injuries