Episode 12: Complex and Displaced Meniscal Tears

From The ViewBox

Dr. Sereni returns to continue his discussion on meniscal injuries. In this podcast Dr. Sereni discusses the evolution of previously discussed basic tears into complex and displaced tears. Guest: Christopher Sereni, MD. Assistant Professor of Radiology, Division of Musculoskeletal Imaging & Intervention, UMMS Dept of Radiology. Host: Christopher Cerniglia, DO, ME, FAOCR. Associate Professor of Radiology, Division of Musculoskeletal Imaging & Intervention, UMMS Dept of Radiology. Review •Abnormal signal or abnormal morphology •Three basic types of tears -Longitudinal vertical (aka the can-opener) -Horizontal (pita bread) -Radial (pizza slicer) -Complex tear - nonstandard combination of basic tear types Tears in the setting of an ACL injury - a frequently overlooked setting •Mensicocapsular separation •Wrisberg rip -ACL tear allows tibia to translate anteriorly -Ligament of Wrisberg causes traction on posterior horn of the lateral meniscus, causing vertical longitudinal tear Displaced tears •Longitudinal vertical --> bucket handle tear -central migration of inner portion with or without flipping -signs - not the be-all end-all -fragment in the notch -double anterior horn -double PCL -Small posterior horn/body •Horizontal tear --> flap tear -inferior flap tear could potentially go unnoticed on arthroscopy -boomerang sign -common displaced tear •Radial oblique tear --> Parrot beak tear -Displaced flap -Parrot beak appearance on axial sequence Resources: • Saad SS, Gorbachova T, Saing M (2015) Meniscal tears: scanned, scoped, and sculpted. Radiographics 35(4):1138–1139 • De Smet AA. How I diagnose meniscal tears on knee MRI. AJR Am J Roentgenol 2012;199(3):481–499.