MR imaging of meniscal cysts: evaluation of location and extension using a three-layer approach (original) (raw)
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Meniscal and ganglion cysts of the knee: MR evaluation
American Journal of Roentgenology, 1988
and ganglion cysts frequently present as palpable masses of the knee but occur at different locations than do popliteal cysts. Meniscal cysts also may be discovered incidentally on studies performed for suspected internal derangement. Sixteen cystic lesions of the knee were evaluated with MR, including I I meniscal cysts and five ganglion cysts. Scans were performed at 1.5 T by using a transmit/receive extremity coil or a receive-only surface coil. Standard spin-echo imaging, including at least one Iong-TR/asymmetric-TE sequence, was performed in all cases. In six patients, gradientecho, reduced flip-angle sequences also were done. All meniscal cysts (but none of the ganglion cysts) were associated with horizontal meniscal tears. Cysts were visualized best on the Iong-TR/TE images; meniscal tears were seen best on the short-TRITE and Iong-TR/short-TE images. Meniscal tears and cysts were also seen well on the fastscanning sequences. Septations were noted in four meniscal cysts and in four ganglion cysts on the long-TRITE images. Long-TRITE images were also useful in showing the relationship between the cyst and joint capsule in three of the ganglion cysts.
Parameniscal cyst formation in the knee is associated with meniscal tear size: An MRI study
The relationship between meniscal tears and parameniscal cyst formation is contentious. We investigated whether the development of a parameniscal cyst is related to the size of the meniscal tear by using magnetic resonance imaging (MRI). Methods: Onthebasis ofaretrospective review ofanMRIdatabase, weidentifiedparameniscal cysts in34patients with adjacent meniscal tears extending to the meniscocapsular junction. The size of the meniscal tear was measured by dividing the length of the tear along two axes: circumferential and radial. We compared parameters, suchasthesizeofthemeniscaltear,thelocationofthetear,thepatternofeachtear,andanyassociatedligamentous injury and intra-articular lesion, between the 34 patients and the 30 control patients who only had meniscal tears with torn components extending to the meniscocapsular junction. Results: Compared with the controls, patients with parameniscal cysts had significantly larger meniscal tears along the circumferential axis (P b 0.001). A critical size of the meniscal tear along the circumferential axis of 12 mm was associated with the formation of a parameniscal cyst. Conclusions: A larger meniscal tear extending into the meniscocapsular junction is more likely to be associated with the occurrence of a parameniscal cyst. The critical size of the meniscal tear, 12 mm along the circumferential axis as identified using MRI, is a discrimination value for parameniscal cyst formation. Level of Evidence: Level III
Diagnostic and interventional imaging, 2018
This article characterizes common meniscal pathologies, reviews magnetic resonance imaging (MRI) diagnostic criteria for meniscal tears, and identifies difficult-to-detect tears and fragments and the best MRI sequences and practices for recognizing these lesions. These difficult-to-diagnose meniscal lesions that radiologists should consider include tears, meniscocapsular separation lesions, and displaced meniscal fragments. Meniscus tears are either vertical, which are generally associated with traumatic injury, horizontal, which are associated with degenerative injury, or combinations of both. MRI has a high sensitivity for tears but not for fragments; MRI performance is also better for medial than lateral meniscal lesions. Fragment detection can be improved by recognizing signs secondary to migration, especially signs of epiphyseal irritation and mechanical impingement. Radial and peripheral tears, as well as those close to the posterior horn insertion, have been traditionally dif...
Acta Radiologica, 2001
Purpose: Meniscal tears associated with displaced fragments are clinically Key words: Knee, meniscus; tear, significant. We propose the ''disproportional posterior horn sign'' as a support-fragment; arthroscopy; MR imaging. ive criterion to identify a posterocentrally displaced meniscal fragment on MR imaging studies. If the meniscal posterior horn in the central portion appears Correspondence: Tiffany Ting-Fang larger than that in the peripheral section, it is considered positive for ''dispro-Shih, Department of Medical portional posterior horn sign''. Imaging, National Taiwan Material and Methods: MR images obtained in 42 patients with 43 lesions, University, Medical College and confirmed to have displaced meniscal tears, were included in this study. The MR Hospital, No. 7, images were retrospectively evaluated for the presence of the ''disproportional Chung-Shan S. Road, Taipei, posterior horn sign'', as well as the other known signs. Taiwan. Results: The ''disproportional posterior horn sign'' was seen in 9 (20.9%) of FAX π886 2 27548108. 43 lesions, including 1 lateral discoid meniscal tear, 5 lateral meniscal tears and 3 medial meniscal tears. Five of them also had other signs of a displaced menis-Accepted for publication 25 January cal fragment. However, the remaining 4 cases only exhibited the ''dispro-2001. portional posterior horn sign''. For the other MR signs, the ''absent bow tie sign'' was detected in 40 (93%) of 43 lesions, the ''flipped meniscus sign'' in 27 (62.8%) of 43 lesions, the ''double posterior cruciate ligament sign'' in 17 (39.5%) of 43 lesions and the ''notch fragment sign'' in 22 (51.2%) of 43 lesions. Conclusion: The ''disproportional posterior horn sign'' is helpful in demonstrating a posterocentrally displaced meniscal fragment, especially when other characteristic signs are unremarkable or absent.
Radiology, 2005
To prospectively evaluate the clinical course of asymptomatic meniscal lesions diagnosed by using magnetic resonance (MR) imaging. Institutional review board approval and informed consent were obtained. The clinical courses of meniscal lesions in 84 asymptomatic knees (in 48 men and 36 women; mean age, 43.6 years; age range, 18-73 years) were assessed. Thirty-one asymptomatic meniscal lesions were depicted among the 84 knees at MR imaging. The follow-up period was at least 2 years (mean, 29.8 months; range, 24-36 months). Knee pain, stiffness, and function during daily and sports activities were assessed by using a visual analogue scale (VAS), on which a score of 0 indicated no pain or complaints and a score of 100 indicated maximal pain and/or complaints. The chi2 test was used for statistical analysis. At follow-up, 12 (39%) of the 31 patients with and 10 (19%) of the 53 patients without meniscal lesions reported having knee pain (P = .046). Nine (29%) patients with and five (9%) ...
Knee Surgery Sports Traumatology Arthroscopy
Purpose The aim of this prospective study was to compare the accuracy of clinical examination and magnetic resonance imaging (MRI) versus arthroscopic findings and to determine the value of an experienced examiner in clinical decision making. Methods A total of 30 patients with a preoperative MRI underwent arthroscopy over a 5-month period. All patients had a clinical examination performed by an experienced knee surgeon, a specialist in general orthopedics, a senior resident, and a fourth-year resident. These examiners recorded and evaluated the results of seven tests: the medial and lateral joint line tenderness test, the McMurray test, the Apley test, the Stienmann I test, the Payr’s test, Childress’ sign, and the Ege’s test. The injury was classified as a meniscal tear if there were two positive tests. Clinical history, physical examination, and MRI findings were compared with the arthroscopic findings. The accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of these methods of evaluation were then calculated. Results Clinical examination performed by an experienced knee surgeon had better specificity (90% vs. 60%), positive predictive value (95% vs. 83%), negative predictive value (90% vs. 86%), and diagnostic accuracy (93% vs. 83%) than MRI for medial meniscal tears. These parameters showed only a marginal difference in lateral meniscal tears. The experienced knee surgeon had better sensitivity, specificity, predictive values, and diagnostic accuracy parameters for medial meniscus tears in comparison with the other three examiners. Conclusion These results indicate that clinical examination by an experienced examiner using multiple meniscus tests is sufficient for a diagnosis of a meniscal tear. Level of evidence II.