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Meniscal Flounce on Knee MRI: Correlation with Meniscal Locations After Positional Changes

Ji Seon Park1, Kyung Nam Ryu1 and Kyoung Ho Yoon2

1 Department of Diagnostic Radiology, Kyung Hee University Hospital, 1, Heokidong Dongdaemun-ku, Seoul, South Korea 130-702.
2 Department of Orthopaedic Surgery, Kyung Hee University Hospital, Seoul, South Korea.


Figure 1
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  		Fig. 1 —Diagram shows measurement for anterior (A) and posterior (P) distances from peripheral meniscal margin to tibial margin for both anterior and posterior horns, indicating meniscal location on tibial plateau. Lines through both peripheral meniscal margin and outermost tibial margin were set perpendicular to baseline along inferior meniscal surface of both anterior and posterior horns, respectively. Anteroposterior distances between these two lines were measured in millimeters.

 

Figure 2
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  		Fig. 2A —Medial meniscal flounce on routine left knee MR images of 43-year-old man with anterior cruciate ligament tear, lateral meniscus tear, and medial meniscus degeneration. Sagittal proton density-weighted (TR/TE, 3,300/16) images show bowtie appearance and next lateral image in neutral (A), maximally extended (B), and maximally flexed (C) knee in a surface coil. From neutral to maximally extended position, flounce disappears, with anterior migration of anterior horn and slightly posterior migration of posterior horn. With maximally flexed knee, flounce is slightly released but is still evident, with posterior migration of both horns. Distances between anterior horn margin and anterior tibial margin (A in Fig. 1) are 5.19 mm in A, 0 mm in B, and 7.74 mm in C, representing anterior migration of anterior horn as knee is extended farther. Distances between posterior horn margin and posterior tibial margin (P in Fig. 1) are 6.64 mm in A, 4.7 mm in B, and 4.2 mm in C.

 

Figure 3
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  		Fig. 2B —Medial meniscal flounce on routine left knee MR images of 43-year-old man with anterior cruciate ligament tear, lateral meniscus tear, and medial meniscus degeneration. Sagittal proton density-weighted (TR/TE, 3,300/16) images show bowtie appearance and next lateral image in neutral (A), maximally extended (B), and maximally flexed (C) knee in a surface coil. From neutral to maximally extended position, flounce disappears, with anterior migration of anterior horn and slightly posterior migration of posterior horn. With maximally flexed knee, flounce is slightly released but is still evident, with posterior migration of both horns. Distances between anterior horn margin and anterior tibial margin (A in Fig. 1) are 5.19 mm in A, 0 mm in B, and 7.74 mm in C, representing anterior migration of anterior horn as knee is extended farther. Distances between posterior horn margin and posterior tibial margin (P in Fig. 1) are 6.64 mm in A, 4.7 mm in B, and 4.2 mm in C.

 

Figure 4
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  		Fig. 2C —Medial meniscal flounce on routine left knee MR images of 43-year-old man with anterior cruciate ligament tear, lateral meniscus tear, and medial meniscus degeneration. Sagittal proton density-weighted (TR/TE, 3,300/16) images show bowtie appearance and next lateral image in neutral (A), maximally extended (B), and maximally flexed (C) knee in a surface coil. From neutral to maximally extended position, flounce disappears, with anterior migration of anterior horn and slightly posterior migration of posterior horn. With maximally flexed knee, flounce is slightly released but is still evident, with posterior migration of both horns. Distances between anterior horn margin and anterior tibial margin (A in Fig. 1) are 5.19 mm in A, 0 mm in B, and 7.74 mm in C, representing anterior migration of anterior horn as knee is extended farther. Distances between posterior horn margin and posterior tibial margin (P in Fig. 1) are 6.64 mm in A, 4.7 mm in B, and 4.2 mm in C.

 

Figure 5
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  		Fig. 3A —Medial meniscal flounce on routine knee MR images of 23-year-old man with no abnormality. Two continuous sagittal proton density-weighted (TR/TE, 3,300/16) images in neutral (A), maximally extended (B), and maximally flexed (C) knee in surface coil. From neutral to maximally extended position, flounce disappears with anterior migration of anterior horn. On maximally flexed knee, flounce also disappears with posterior migration of both horns. Distances representing anterior migration of anterior horn with more extension of knee (A in Fig. 1) are 0 mm in A, -2.1 mm in B, and 4.25 mm in C. Distances between posterior horn margin and posterior tibial margin (P in Fig. 1) are 5.31 mm in A, 5.35 mm in B, and 3.98 mm in C.

 

Figure 6
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  		Fig. 3B —Medial meniscal flounce on routine knee MR images of 23-year-old man with no abnormality. Two continuous sagittal proton density-weighted (TR/TE, 3,300/16) images in neutral (A), maximally extended (B), and maximally flexed (C) knee in surface coil. From neutral to maximally extended position, flounce disappears with anterior migration of anterior horn. On maximally flexed knee, flounce also disappears with posterior migration of both horns. Distances representing anterior migration of anterior horn with more extension of knee (A in Fig. 1) are 0 mm in A, -2.1 mm in B, and 4.25 mm in C. Distances between posterior horn margin and posterior tibial margin (P in Fig. 1) are 5.31 mm in A, 5.35 mm in B, and 3.98 mm in C.

 

Figure 7
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  		Fig. 3C —Medial meniscal flounce on routine knee MR images of 23-year-old man with no abnormality. Two continuous sagittal proton density-weighted (TR/TE, 3,300/16) images in neutral (A), maximally extended (B), and maximally flexed (C) knee in surface coil. From neutral to maximally extended position, flounce disappears with anterior migration of anterior horn. On maximally flexed knee, flounce also disappears with posterior migration of both horns. Distances representing anterior migration of anterior horn with more extension of knee (A in Fig. 1) are 0 mm in A, -2.1 mm in B, and 4.25 mm in C. Distances between posterior horn margin and posterior tibial margin (P in Fig. 1) are 5.31 mm in A, 5.35 mm in B, and 3.98 mm in C.

 

Figure 8
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  		Fig. 4A —Medial meniscal flounce on routine knee MR images of 34-year-old man with medial collateral ligament tear. Sagittal proton density-weighted (TR/TE, 3,300/16) images in neutral (A), maximally extended (B), and maximally flexed (C) knee in a surface coil. From neutral to maximally extended position, flounce disappears. On maximally flexed knee, flounce is accentuated, with posterior migration of anterior horn and slightly anterior migration of posterior horn.

 

Figure 9
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  		Fig. 4B —Medial meniscal flounce on routine knee MR images of 34-year-old man with medial collateral ligament tear. Sagittal proton density-weighted (TR/TE, 3,300/16) images in neutral (A), maximally extended (B), and maximally flexed (C) knee in a surface coil. From neutral to maximally extended position, flounce disappears. On maximally flexed knee, flounce is accentuated, with posterior migration of anterior horn and slightly anterior migration of posterior horn.

 

Figure 10
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  		Fig. 4C —Medial meniscal flounce on routine knee MR images of 34-year-old man with medial collateral ligament tear. Sagittal proton density-weighted (TR/TE, 3,300/16) images in neutral (A), maximally extended (B), and maximally flexed (C) knee in a surface coil. From neutral to maximally extended position, flounce disappears. On maximally flexed knee, flounce is accentuated, with posterior migration of anterior horn and slightly anterior migration of posterior horn.

 

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