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AJR 2005; 184:200-204
© American Roentgen Ray Society


Original Report

The "Floating" Meniscus: MRI in Knee Trauma and Implications for Surgery

Ravi S. Bikkina1, Charles A. Tujo2, Albert B. Schraner2 and Nancy M. Major1

1 Department of Radiology, Duke University Medical Center, Erwin Rd., PO Box 3808, Durham, NC 27710.
2 Department of Diagnostic Imaging, David Grant Medical Center, 101 Bodin Cir., Travis Air Force Base, CA 94535.

OBJECTIVE. We describe 21 cases involving meniscal injury in which the meniscus appears free-floating on MRI of the knee. In these cases, the meniscus is completely surrounded by fluid. Correlation with surgical reports shows that the "floating" meniscus corresponds to a meniscal avulsion or detachment from the tibial plateau with an associated disruption of the meniscotibial coronary ligaments, which attach the meniscus to the tibia, allowing fluid to encompass the meniscus. A floating meniscus on MRI may represent a new specific finding for an uncommon form of meniscal injury known as meniscal avulsion.

CONCLUSION. The presence of a floating meniscus on MRI is a result of significant trauma to the knee leading to meniscal avulsion and is often associated with significant ligamentous injury. Alerting the surgeon to the presence of a meniscal avulsion facilitates appropriate surgical planning with meniscal reattachment to the tibial plateau.


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