Clinical, MRI, and Arthroscopic Findings Associated with Failure to Diagnose a Lateral Meniscal Tear on Knee MRI
Arthur A. De Smet1 and
Rajat Mukherjee2
1 Department of Radiology, University of Wisconsin School of Medicine and Public
Health, 600 Highland Ave., E3/311, Madison, WI 53792.
2 Department of Statistics, University of Wisconsin School of Medicine and
Public Health, Madison, WI.
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Fig. 1A —23-year-old woman with originally missed root tear of lateral
meniscus seen on retrospective review. Tear was débrided during
arthroscopy for anterior cruciate ligament reconstruction. Sagittal fast
spin-echo proton density-weighted image shows signal contacting inferior
surface of root (arrow). Note is also made of anterior fragments of
torn anterior cruciate ligament.
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Fig. 1B —23-year-old woman with originally missed root tear of lateral
meniscus seen on retrospective review. Tear was débrided during
arthroscopy for anterior cruciate ligament reconstruction. Coronal
fat-saturated fast spin-echo proton density-weighted image shows disruption of
attachment of root with internal signal (arrow).
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Fig. 2 —15-year-old girl with originally missed longitudinal peripheral tear
of posterior horn of lateral meniscus seen on retrospective review. Tear was
repaired with sutures. Sagittal fast spin-echo proton density-weighted image
shows peripheral longitudinal tear with vertical orientation
(arrow).
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Fig. 3A —17-year-old girl with originally missed longitudinal peripheral tear
of posterior horn of lateral meniscus seen on retrospective review. Tear was
repaired with sutures. Sagittal fast spin-echo proton density-weighted
(A) and sagittal fat-saturated fast spin-echo T2-weighted (B)
images. Peripheral tear (arrows) is better seen on fluid-sensitive
T2-weighted image than on proton density-weighted image. Prominent bone
bruises are also seen in anterior aspect of lateral femoral condyle and
posterior aspect of tibia in this patient who also had anterior cruciate
ligament tear.
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Fig. 3B —17-year-old girl with originally missed longitudinal peripheral tear
of posterior horn of lateral meniscus seen on retrospective review. Tear was
repaired with sutures. Sagittal fast spin-echo proton density-weighted
(A) and sagittal fat-saturated fast spin-echo T2-weighted (B)
images. Peripheral tear (arrows) is better seen on fluid-sensitive
T2-weighted image than on proton density-weighted image. Prominent bone
bruises are also seen in anterior aspect of lateral femoral condyle and
posterior aspect of tibia in this patient who also had anterior cruciate
ligament tear.
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Fig. 4A —16-year-old boy with originally missed radial tear of body of
lateral meniscus that was questionably seen on retrospective review. Tear was
trimmed to saucerize lesion. Sagittal fast spin-echo proton density-weighted
(A) and sagittal fat-saturated fast spin-echo T2-weighted (B)
images. Tear is seen as subtle area of increased signal intensity on free edge
of meniscus (arrow, A) in A but is not evident in
B. No other sagittal or coronal image depicted meniscal abnormality
suggesting tear.
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Fig. 4B —16-year-old boy with originally missed radial tear of body of
lateral meniscus that was questionably seen on retrospective review. Tear was
trimmed to saucerize lesion. Sagittal fast spin-echo proton density-weighted
(A) and sagittal fat-saturated fast spin-echo T2-weighted (B)
images. Tear is seen as subtle area of increased signal intensity on free edge
of meniscus (arrow, A) in A but is not evident in
B. No other sagittal or coronal image depicted meniscal abnormality
suggesting tear.
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Copyright © 2008 by the American Roentgen Ray Society.
