MRI of Acute Meniscal Injury Associated with Tibial Plateau Fractures: Prevalence, Type, and Location
Antti O. T. Mustonen1,
Mika P. Koivikko1,
Jan Lindahl2 and
Seppo K. Koskinen1
1 Department of Radiology, Helsinki Medical Imaging Center, Helsinki University
Central Hospital, Toolo Trauma Center, Topeliuksenkatu 5, FIN–00029,
Helsinki, Finland.
2 Department of Orthopedics and Traumatology, Helsinki University Central
Hospital, Toolo Trauma Center, Helsinki, Finland.
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Fig. 1 —76-year-old man with MDCT findings of B2 tibial plateau
fracture after simple fall. Coronal T2-weighted fat-suppressed MR image
(TR/TE, 4,740/40) shows radial tear (arrow) in posterior horn of
medial meniscus. Findings were not verified with arthroscopy.
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Fig. 2A —Arbeitsgemeinschaft für
Osteosynthesefragen–Orthopaedic Trauma Association classification of
tibial plateau fractures. A1.3 fractures were included in study if they
existed with type B or C fractures. Drawing shows avulsion fracture (A1.3) of
anterior or posterior eminence.
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Fig. 2B —Arbeitsgemeinschaft für
Osteosynthesefragen–Orthopaedic Trauma Association classification of
tibial plateau fractures. A1.3 fractures were included in study if they
existed with type B or C fractures. Drawings show type B fractures (not
specific to medial or lateral plateau) involve one condyle. Type B1 (B)
is pure slit fracture, B2 (C) is pure depression fracture, and B3
(D) is split–depression fracture.
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Fig. 2C —Arbeitsgemeinschaft für
Osteosynthesefragen–Orthopaedic Trauma Association classification of
tibial plateau fractures. A1.3 fractures were included in study if they
existed with type B or C fractures. Drawings show type B fractures (not
specific to medial or lateral plateau) involve one condyle. Type B1 (B)
is pure slit fracture, B2 (C) is pure depression fracture, and B3
(D) is split–depression fracture.
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Fig. 2D —Arbeitsgemeinschaft für
Osteosynthesefragen–Orthopaedic Trauma Association classification of
tibial plateau fractures. A1.3 fractures were included in study if they
existed with type B or C fractures. Drawings show type B fractures (not
specific to medial or lateral plateau) involve one condyle. Type B1 (B)
is pure slit fracture, B2 (C) is pure depression fracture, and B3
(D) is split–depression fracture.
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Fig. 2E —Arbeitsgemeinschaft für
Osteosynthesefragen–Orthopaedic Trauma Association classification of
tibial plateau fractures. A1.3 fractures were included in study if they
existed with type B or C fractures. Drawings show type C fractures involve
both condyles. Type C1 (E) is metaphyseal simple fracture, C2
(F) is metaphyseal multifragment fracture, and C3 (G) is
multifragment fracture.
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Fig. 2F —Arbeitsgemeinschaft für
Osteosynthesefragen–Orthopaedic Trauma Association classification of
tibial plateau fractures. A1.3 fractures were included in study if they
existed with type B or C fractures. Drawings show type C fractures involve
both condyles. Type C1 (E) is metaphyseal simple fracture, C2
(F) is metaphyseal multifragment fracture, and C3 (G) is
multifragment fracture.
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Fig. 2G —Arbeitsgemeinschaft für
Osteosynthesefragen–Orthopaedic Trauma Association classification of
tibial plateau fractures. A1.3 fractures were included in study if they
existed with type B or C fractures. Drawings show type C fractures involve
both condyles. Type C1 (E) is metaphyseal simple fracture, C2
(F) is metaphyseal multifragment fracture, and C3 (G) is
multifragment fracture.
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Fig. 3A —28-year-old man with MDCT findings of B2 and A1.3 tibial
plateau fractures after traffic accident. Findings were verified with
arthroscopy. Coronal T2-weighted fat-suppressed MR image (TR/TE, 3,800/40)
shows fracture line (arrows).
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Fig. 3B —28-year-old man with MDCT findings of B2 and A1.3 tibial
plateau fractures after traffic accident. Findings were verified with
arthroscopy. Sagittal proton density MR image (1,700/20) shows longitudinal
tear (arrow) in posterior horn of medial meniscus.
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Fig. 4A —33-year-old man with MDCT findings of B2 tibial plateau
fracture after traffic accident. Findings were verified with arthroscopy.
Coronal T2-weighted fat-suppressed (TR/TE, 4,740/40) (A) and sagittal
proton-density (1,800/20) (B) MR images show horizontal tear
(arrow) in posterior horn of medial meniscus. Bone marrow edema is
present in proximal tibia (arrowheads, A).
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Fig. 4B —33-year-old man with MDCT findings of B2 tibial plateau
fracture after traffic accident. Findings were verified with arthroscopy.
Coronal T2-weighted fat-suppressed (TR/TE, 4,740/40) (A) and sagittal
proton-density (1,800/20) (B) MR images show horizontal tear
(arrow) in posterior horn of medial meniscus. Bone marrow edema is
present in proximal tibia (arrowheads, A).
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Fig. 5A —40-year-old woman after simple fall. Findings were verified
with arthroscopy. Coronal MDCT image shows B2 tibial plateau fracture of
lateral condyle with 3-mm articular depression (arrows).
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Fig. 5B —40-year-old woman after simple fall. Findings were verified
with arthroscopy. Coronal T2-weighted fat-suppressed MR image (TR/TE,
3,800/40) shows complex (longitudinal and flap) tear (arrows) in
posterior horn of lateral meniscus. No isolated flap tear is visible. Bone
marrow edema is present in proximal tibia (arrowheads).
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Fig. 5C —40-year-old woman after simple fall. Findings were verified
with arthroscopy. Sagittal proton-density MR image (1,800/20) shows part of
meniscus (white arrow) is flipped behind and below posterior horn.
Articular depression (black arrow) is visible.
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Fig. 6B —32-year-old man after traffic accident. Findings were
verified with arthroscopy. Coronal T2-weighted fat-suppressed (TR/TE,
4,200/40) (B) and T1-weighted (500/22) (C) MR images show
bucket-handle tear. Part of torn meniscus body is flipped medially
(arrow). Rest of body is in normal position (arrowhead).
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Fig. 6C —32-year-old man after traffic accident. Findings were
verified with arthroscopy. Coronal T2-weighted fat-suppressed (TR/TE,
4,200/40) (B) and T1-weighted (500/22) (C) MR images show
bucket-handle tear. Part of torn meniscus body is flipped medially
(arrow). Rest of body is in normal position (arrowhead).
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Fig. 7B —17-year-old woman after simple fall. Findings were verified
with arthroscopy. Sagittal proton-density MR image (TR/TE, 1,800/20) shows
contusion (arrow) in posterior horn of lateral meniscus as area of
increased signal intensity. Asterisk indicates proximal fibula.
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