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Lesions of the Menisci of the Knee

Value of MR Imaging Criteria for Recognition of Unstable Lesions

B. C. Vande Berg1, P. Poilvache2, F. Duchateau1, F. E. Lecouvet1, J. E. Dubuc2, B. Maldague1 and J. Malghem1

1 Department of Radiology, Cliniques Universitaires St. Luc, Université Catholique de Louvain, 10 Ave. Hippocrate, 1200 Brussels, Belgium.
2 Department of Orthopedic Surgery, Cliniques Universitaires St. Luc, Université Catholique de Louvain, 1200 Brussels, Belgium.



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  		Fig. 1A. —70-year-old man with chronic right knee pain. Parasagittal intermediate-weighted spin-echo MR image shows horizontal tear (white arrow) in posterior horn of medial meniscus. Note contour irregularity (black arrow) of inner margin.

 


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  		Fig. 1B. —70-year-old man with chronic right knee pain. MR image medial to A shows radial tear (arrow) of meniscal body. Note meniscal fragment (arrowheads) flipped anteriorly and inferiorly.

 


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  		Fig. 1C. —70-year-old man with chronic right knee pain. Coronal gradient-echo T2*-weighted MR image shows meniscal fragment (arrowheads) displaced in inferior recess. Unstable meniscal lesion with displaced fragment was found at arthroscopy.

 


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  		Fig. 2A. —46-year-old man with left knee pain. Parasagittal intermediate-weighted spin-echo MR image shows contour irregularity (arrow) of apex of posterior horn of medial meniscus.

 


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  		Fig. 2B. —46-year-old man with left knee pain. MR image medial to A shows vertical tear (arrow).

 


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  		Fig. 2C. —46-year-old man with left knee pain. MR image medial to B shows horizontal tear (arrow).

 


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  		Fig. 2D. —46-year-old man with left knee pain. Coronal gradient-echo T2*-weighted MR image of posterior horn of medial meniscus shows focal substance loss (arrow) and horizontal cleavage plane (arrowhead) that extends to posteromedial aspect of medial meniscus. Presence of two lesion patterns and two cleavage planes, along with visibility of lesion on six coronal and five sagittal contiguous sections (not shown) suggests unstable tear, which was confirmed at arthroscopy.

 


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  		Fig. 3. —52-year-old man with right knee pain. Sagittal T2-weighted fast spin-echo MR image shows tear of posterior horn of medial meniscus with high signal intensity (arrow) equivalent to that of joint fluid in meniscus. Lesion was found unstable at arthroscopy, with large meniscal flap of posterior horn of medial meniscus.

 

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