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Medial Meniscus Extrusion on Knee MRI: Is Extent Associated with Severity of Degeneration or Type of Tear?

C. Rosalia Costa1, William B. Morrison2 and John A. Carrino3

1 Department of Radiology, Instituto Portugues de Oncologia de Francisco Gentil, Porto 4200, Portugal.
2 Department of Radiology, Thomas Jefferson University Hospital, 111 S 11th St., Ste. 3390, Philadelphia, PA 19107.
3 Department of Radiology, Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115.



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  		Fig. 1. —Measurement of meniscal extrusion in 72-year-old woman. Coronal fast spin-echo intermediate-weighted image (TR/TE, 3,000/35) of knee obtained through mid portion of medial femoral condyle. Vertical line (white line) is drawn intersecting margin of medial tibial plateau at site of transition from horizontal to vertical. Extrusion is measured from this line to outer edge of meniscus (black line).

 


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  		Fig. 2A. —45-year-old man with oblique tear of posterior horn and body of medial meniscus and minor extrusion (≤ 3 mm). Sagittal spin-echo intermediate-weighted image (TR/TE, 1,200/20) (A) and sagittal fast spin-echo T2-weighted image (5,000/90) (B) obtained through medial meniscus show high signal in posterior horn (arrow) in pattern consistent with oblique undersurface tear.

 


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  		Fig. 2B. —45-year-old man with oblique tear of posterior horn and body of medial meniscus and minor extrusion (≤ 3 mm). Sagittal spin-echo intermediate-weighted image (TR/TE, 1,200/20) (A) and sagittal fast spin-echo T2-weighted image (5,000/90) (B) obtained through medial meniscus show high signal in posterior horn (arrow) in pattern consistent with oblique undersurface tear.

 


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  		Fig. 2C. —45-year-old man with oblique tear of posterior horn and body of medial meniscus and minor extrusion (≤ 3 mm). Coronal fast spin-echo fat-saturated intermediate-weighted image (2,800/40) shows extension of meniscal tear to body (arrow), with minor extrusion (2 mm).

 


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  		Fig. 3A. —48-year-old woman with large radial tear of body of medial meniscus associated with major extrusion (> 3 mm). Axial fast spin-echo T2-weighted MR image (TR/TE, 3,800/90) shows radial tear of body of medial meniscus (arrow) involving more than 50% of meniscal width.

 


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  		Fig. 3B. —48-year-old woman with large radial tear of body of medial meniscus associated with major extrusion (> 3 mm). Sagittal intermediate-weighted image (3,800/45) shows vertical radial tear of medial meniscus body (arrow).

 


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  		Fig. 3C. —48-year-old woman with large radial tear of body of medial meniscus associated with major extrusion (> 3 mm). Coronal STIR image (2,160/25; inversion time, 80 msec) shows extrusion of meniscal body (arrow) (7 mm).

 


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  		Fig. 4A. —51-year-old man with complex tear of body and posterior horn of medial meniscus associated with major extrusion. Coronal spin-echo intermediate-weighted image (TR/TE, 3,800/45) shows complex signal (arrow) extending to meniscal surface at posterior horn.

 


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  		Fig. 4B. —51-year-old man with complex tear of body and posterior horn of medial meniscus associated with major extrusion. Coronal STIR image (2,160/25; inversion time, 80 msec) obtained through medial meniscus body (arrow) shows extrusion (5 mm).

 


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  		Fig. 5A. —47-year-old man with radial tear involving meniscal "root" with major extrusion. Sagittal spin-echo intermediate-weighted image (TR/TE, 1,000/20) (A) and coronal STIR image (2,400/25; inversion time, 80 msec) (B) show large radial tear involving posterior meniscal "root" (arrows).

 


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  		Fig. 5B. —47-year-old man with radial tear involving meniscal "root" with major extrusion. Sagittal spin-echo intermediate-weighted image (TR/TE, 1,000/20) (A) and coronal STIR image (2,400/25; inversion time, 80 msec) (B) show large radial tear involving posterior meniscal "root" (arrows).

 


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  		Fig. 5C. —47-year-old man with radial tear involving meniscal "root" with major extrusion. Coronal STIR image (2,400/25; inversion time, 80 msec) obtained midway through meniscal body (arrow) shows associated extrusion (6 mm).

 

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