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Radial Tear of the Medial Meniscal Root: Reliability and Accuracy of MRI for Diagnosis

¹ Department of Radiology, Kangnam St. Mary's Hospital, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul 137-701, South Korea.
² Department of Orthopedic Surgery, Kangnam St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.

View larger version (24K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1 —Superior-view drawing denotes tibial insertion sites of menisci in relation to cruciate ligaments. Black arrow indicates posterior root of medial meniscus; white arrow, posterior root of lateral meniscus; black arrowhead, anterior root of medial meniscus; white arrowhead, anterior root of lateral meniscus. MM = medial meniscus, LM = lateral meniscus, P = posterior cruciate ligament, A = anterior cruciate ligament.

View larger version (9K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2 —Receiver operating characteristic curves show reader confidence in detecting radial tears of medial meniscal root. Points show true-positive and false-positive fractions at each level of confidence for each reader.

View larger version (158K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —55-year-old woman with medial meniscal root radial tear correctly interpreted on MR images. Sagittal T1-weighted (TR/TE, 600/10) (A) and T2-weighted (3,000/85; echo-train length, 8) (B) images show diffuse high signal intensity (arrow) in posterior medial meniscal root.

View larger version (162K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —55-year-old woman with medial meniscal root radial tear correctly interpreted on MR images. Sagittal T1-weighted (TR/TE, 600/10) (A) and T2-weighted (3,000/85; echo-train length, 8) (B) images show diffuse high signal intensity (arrow) in posterior medial meniscal root.

View larger version (170K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3C —55-year-old woman with medial meniscal root radial tear correctly interpreted on MR images. Coronal intermediate (3,000/32; echo-train length, 4) (C) and T2-weighted (3,000/81, echo-train length, 4) (D) images show bandlike area of high signal intensity (arrow) in posterior medial meniscal root.

View larger version (168K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3D —55-year-old woman with medial meniscal root radial tear correctly interpreted on MR images. Coronal intermediate (3,000/32; echo-train length, 4) (C) and T2-weighted (3,000/81, echo-train length, 4) (D) images show bandlike area of high signal intensity (arrow) in posterior medial meniscal root.

View larger version (162K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —40-year-old woman with false-positive findings. Sagittal T1-weighted (TR/TE, 600/10) (A) and T2-weighted (3,000/85; echo-train length, 8) (B) images show diffuse area of high signal intensity (arrow) in posterior medial meniscal root.

View larger version (161K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —40-year-old woman with false-positive findings. Sagittal T1-weighted (TR/TE, 600/10) (A) and T2-weighted (3,000/85; echo-train length, 8) (B) images show diffuse area of high signal intensity (arrow) in posterior medial meniscal root.

View larger version (168K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4C —40-year-old woman with false-positive findings. Coronal intermediate image (3,000/26; echo-train length, 4) shows very thick bandlike area of high signal intensity (arrow) in posterior medial meniscal root. Another bandlike area of high signal intensity is present in medial aspect.

View larger version (166K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4D —40-year-old woman with false-positive findings. Coronal T2-weighted image (3,000/89; echo-train length, 4) shows ill-defined focal area of high signal intensity (arrow) in posterior medial meniscal root. Another bandlike area of high signal intensity is present in medial aspect. MR images were interpreted as radial tear of medial meniscal root and another tear in posterior horn of medial meniscus. Arthroscopy revealed complex tear in posterior horn of medial meniscus instead of medial meniscal root radial tear.

View larger version (158K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5A —60-year-old man with false-negative findings. Sagittal T1-weighted (TR/TE, 600/10) (A) and T2-weighted (3,000/85; echo-train length, 8) (B) images show diffuse area of high signal intensity (arrow) in posterior medial meniscal root.

View larger version (160K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5B —60-year-old man with false-negative findings. Sagittal T1-weighted (TR/TE, 600/10) (A) and T2-weighted (3,000/85; echo-train length, 8) (B) images show diffuse area of high signal intensity (arrow) in posterior medial meniscal root.

View larger version (154K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5C —60-year-old man with false-negative findings. Coronal intermediate image (3,000/25; echo-train length, 4) shows horizontally oriented area of high signal intensity (arrow) in posterior horn of medial meniscus extending to medial meniscal root.

View larger version (158K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5D —60-year-old man with false-negative findings. Coronal T2-weighted image (3,000/88; echo-train length, 4) shows horizontal area of high signal intensity (arrow) in posterior horn of medial meniscus without definite extension to medial meniscal root. MR images were interpreted as showing horizontal tear in posterior horn of medial meniscus extending to meniscal root. At arthroscopy, radial tear of medial meniscal root was found to coexist with horizontal tear in posterior horn of medial meniscus.

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