Torn meniscus ppt free download as powerpoint presentation. Learn what happens when you tear your meniscus and how these tears are treated. Reliability of clinical diagnosis in meniscal tears. Download 1,484 meniscus stock photos for free or amazingly low rates. The meniscus is a cshaped fibrocartilaginous structure in the knee incompletely covering the surface of the tibia where it articulates with the femur. Disc like configuration commonly affects lateral meniscus imaging. The mri diagnosis performance is high specificity and sensitivity in diagnosing meniscal tears is high, with a sensitivity of 93. Some technical advances have improved the diagnostic capabilities of mri so that diagnoses, which may change the therapeutic approach, such as a partial tear of the anterior cruciate ligament or confirmation of unstable meniscal injuries, are now made easier.
When doctors and patients refer to torn cartilage in the knee, they actually may be referring to an injury to a meniscus at the top of one of the tibiae. Accurate and timely diagnosis of a meniscal tear is critical for reducing morbidity and planning treatment. Extends from the inner free edge of the meniscus and runs perpendicular. To avoid errors in diagnosing meniscal tears, those interpreting mr examinations of the knee need to be aware of the attachments of the menisci and the normal variations in meniscal anatomy that may resemble a meniscal tear. The meniscus is a type of cartilage in your knee joint. Knee meniscus rupture an overview sciencedirect topics. Any information contained in this pdf file is automatically generated from digital. Medial meniscus posterior root tears mmprts disrupt the continuity of the circumferential fibers, leading to loss of hoop tension, loss of loadsharing ability, abnormal rotation of the tibia, and unacceptable peak pressures 1,2,3,4. The factors contributing to missed meniscal tear in the setting of acl injury are the performance of the mri assessment shortly after the traumatic event, small of the tear i. Commonest type of tear in lateral meniscus was horizontal tear 42. There are three basic mr characteristicscriteria of meniscal tears 5. Knee cartilage injuries including meniscal tears doctor. Magnetic resonance imaging mri is a test that provides pictures of organs, bones, and joints. Meniscal tears can be assessed arthroscopically for stability and vascularity.
Doctor answers on symptoms, diagnosis, treatment, and more. This book, published in cooperation with esska, provides an exhaustive. The tibial intercondylar eminence can limit inward. May 19, 2008 data from 565 knee arthroscopies performed by two experienced knee surgeons between 2002 and 2005 for degenerative joint disorders, ligament injuries, loose body removals, lateral release of the patellar retinaculum, plica division, and adhesiolysis was prospectively collected. Pdf we investigated 3 knees with suspected meniscal or cruciate injuries by magnetic resonance. Menisci can be torn during innocuous activities such as walking or squatting. Meniscus tears are among the most common knee injuries. Xrays may be necessary, to rule out broken bones and other problems. Mri has been found to be extremely useful in diagnosing displaced meniscal tears, particularly, the buckethandle tears. With a sensitivity of 95% and a specificity of 81% for medial meniscal tears and sensitivity of 85% and a specificity of 93% for lateral meniscal tears 2,5, mri is the modality of choice when a meniscal tear is suspected, with sagittal images being the most sensitive 5. Mr imaging of meniscal tears with discoid lateral meniscus. For each finding and diagnosis, the book provides a complete list of differential diagnoses as well as the features that will help the clinician differentiate diseases.
Buckethandle tears are usually longitudinal tears of the menisci with an attached fragment displaced away from the meniscus. Diagnosis of meniscal tear is always challenging even with high strength mri. Meniscal tears isolated to the posterior root of the lateral meniscus can be subjectively difficult to evaluate because of the anterior oblique course of the posterior root attachment. They often tend to be radial tears extending into the meniscal root. Symptomatic, radiographically confirmed osteoarthritis of the knee affects more than 9 million people in the united states. This disparity in motion contributes to the frequency in which each meniscus is injured. Pdf magnetic resonance imaging in the evaluation of meniscal tear.
The meniscus is the primary shock absorber in our knee. Chris centeno goes over what to look for on your mri and the different types of meniscus tears. Clinical examination, mri and arthroscopy in meniscal and. Case study meniscus tears and osteochondral fractures.
Sports injury medicine department 9250 sw hall blvd. The meniscus plays a critical role in maintaining the well being of our knees. Each type of meniscal tear has its own characteristics on mri, but in most cases, the following can be seen 3. According to one source, they are thought to account for 10% of all arthroscopic meniscectomies 5. As we age, this cartilage begins to lose elasticity and can easily be torn without any type of trauma. The sensitivity for diagnosing a meniscal tear was significantly higher when the tear involved more than onethird of the meniscus or the anterior horn. It is important to note that not all meniscal and acl tears require surgery. Racgp meniscal tear presentation, diagnosis and management. The menisci are especially vulnerable to injuries in which there is both compression and twisting applied across the knee. A common injury among elite, recreational, and youth athletes is the anterior cruciate ligament acl tear. Rehabilitation exercises a meniscus tear is a common knee joint injury.
Meniscal bucket handle tear flipped meniscus radiology. Powerpoint presentation about 5 minutes long on a surgery i witnessed. It makes these images by using a magnetic field and pulses of radio wave energy. In older athletes, many meniscal tears are the result of trivial trauma, like. How to read an mri of a medial meniscus tear minnesota. To diagnose a meniscus tear, your doctor will give you a thorough exam. Mr appearances of surgically proved torn discoid lateral menisci dlm were studied in 57 knees 40 patients. Arthroscopic outsidein technique reported in the literature by warren and more recently. It has been shown that meniscal tears are exclusively mribased in. A subset of 109 patients from the above group who sequentially had clinical examination, mri and arthroscopy for. While mris can help your doctor make a diagnosis, they arent considered 100 percent.
The medial meniscus is injured much more often than the lateral menis cus, with the posterior horn being the most afflicted component. Meniscal root tears are a type of meniscal tear in the knee where the tear extends to either the anterior or posterior meniscal root attachment to the central tibial plateau. Meniscal tears can occur when the knee is forcefully twisted, sustains a direct blow, deep squatting or during activities that require changing directions. Horizontal tear was commonest 12% followed by complex tear 11%, bucket handle tear 07%, radial tear 3% and longitudinal tear 2% in medial meniscus.
On mri, this tear pattern manifests as a full thickness vertical peripheral tear in the redred zone of the medial meniscal posterior horn via linear high t2 fluid intensity signal extending from. Jun 16, 2012 injury a 20 year old male track athlete 5k and 10k distance events 3 years prior, consistent discomfort and pain along l medial joint line 4 weeks prior, escalated to extreme pain spoke with atc and consulted physicians preoperative exam and mri revealed a medial meniscus tear did not respond well to conservative. In 1948 fairbank first reported the roentenographic changes after meniscectomy. The meniscus sits between the cartilage surfaces of the bone to distribute weight and to improve the stability of the joint. Pdf magnetic resonance imaging of meniscal and cruciate injuries. Meniscal tears isolated to the posterior root of the medial meniscus can be detected with a high sensitivity of 86%90% and a high specificity of 94%95% 31. Mri is often requested to detect displaced meniscal tears because they often require often surgery. When there is an acl tear, particular attention should be paid on mri to the lateral meniscus because in one study lateral meniscal root tears were found in 8% of patients with acl tears but in only 0. Researchers utilize mri to investigate how tears heal. They can also be torn by traumatic force encountered in. Medial meniscus tear knee mri mri brain radiology imaging nuclear medicine medical anatomy knee surgery neurology nursing notes. Can you read your own knee mri for a meniscus tear.
When people talk about torn cartilage in the knee, they are usually referring to a torn meniscus. Ayurvedic treatment for meniscal tear doctors answer your. Meniscal function is essential to normal function of the knee joint when the menisci is removed the joint contact area is reduced by 40% the contact area is 2. If you are young and athletic, this should be fixed with surgery. A concise reference for everyday practice practical differential diagnosis in ct and mri is a onestop resource for the differential diagnosis of common and rare radiologic findings and conditions in all regions of the body. How to read knee mri of medial meniscus tear video.
Arthroscopic meniscal repair has become the treatment of choice when the tear is located in the peripheral rim. Mri of the knee for meniscal and anterior cruciate. Mr imagingbased diagnosis and classification of meniscal. They may also prescribe physical therapy and antiinflammatory medication to help with the pain and swelling. It also helps stabilize your knee and keep it from wearing out at a young age. Knee tuner is designed to help you maintain strong, healthy knee joints.
Mri made easy for beginners 2nd edition pdf magnetic. The prevalence of asymptomatic tears, which typically are horizontal tears, increases with age 1,2. Mri has high sensitivity and specificity for detecting meniscal tears in older patients, and ultrasound imaging is almost as good. These pathological characteristics lead to degenerative arthritic changes in the knee joint 1, 3. Even partial meniscectomy may lead to osteoarthritis.
This clinical guide provides a special focus on the normal meniscal mechanism, body and function. Surgery versus physical therapy for a meniscal tear and. Sports knee injuries assessment and management orthosports. New way to evaluate meniscus tear outcomes researchers. Preliminary diagnosis of medial meniscus posterior root. During the last few decades, as the management of meniscal trauma has evolved, and knowledge gained on meniscal function, the orthopaedic surgeon has attempted to preserve the meniscus whenever possible. Meniscus tears will not show up on xrays so your physician may also order a mri of the knee. Mri made easy for beginners 2nd edition pdf for free. There are different types of meniscus tears and a horizontal cleavage tear occurs within the fibers of the meniscus and splits the meniscus in the top and bottom pieces. This is important as the knee joint is used in most activities.
Optimizing recovery after knee meniscal or cartilage. Mri gives a good picture of the size of a meniscus tear and where it is. A tear of a meniscus is a rupturing of one or more of the fibrocartilage strips in the knee called menisci. Meniscus stock photos download 1,484 royalty free photos. He or she will want to hear details about how you got your injury. When a radial tear is present in the posterior root of the lateral meniscus, the appearance may be the same. Mri is a highly accurate imaging method for diagnosing meniscal tears. The meniscus is a tough, rubbery piece of cartilage that acts as a shock absorber between your femur and tibia on both the medial and lateral aspects of your knee. Magnetic resonance imaging mri has now an indisputable role for the diagnosis of meniscus and ligament injuries of the knee. The mr images are uptodate, well labeled, and pertinent to todays imaging practice. Nonabsorbable 20or0 interrupted suture is used to repair the meniscus tear to adjacent meniscal tissue or the peripheral capsule. Occasionally it can be difficult to diagnose a tear in a discoid meniscus on mri because the meniscus may have diffuse internal signal that contacts one or both articular surfaces of the meniscus without the presence of a tear. Meniscal pathology and therapy are depicted in detail, followed by the presentation of longterm experience of meniscal transplantation and a look into the future of meniscal surgery. There is a medial meniscus, on the inner part of the knee, and a lateral meniscus on the outer aspect of the knee.
Mar 22, 2017 in the two most recent series, meniscus mri and mri of the supporting structures, we focus on two important areas of assessment. Accuracy of mri in the diagnosis of meniscal tears in. Any information contained in this pdf file is automatically generated from digital material. An mri will be able to take pictures of cartilage and ligaments to determine if theres a meniscus tear. Meniscus tear article about meniscus tear by the free. Mri of the knee a guide to evaluation and reporting. Some of the tears located in one part were noted extending to other parts of meniscus. Delayed, gadoliniumenhanced mri of cartilage dgemric is useful for assessing cartilage health. Detached meniscal tissue is referred to as a free meniscal fragment. One hundred and fifty patients were clinically diagnosed to have meniscal tears.
Las vegas, nv an individuals meniscus cushion in the knee is one of the most important ligaments in the leg providing stability, load bearing and preservation of the knee joint. Meniscus tear treatment without surgery with 3 exercises see more. Meniscus tear exercises in pdf exercise, periodic table, math. The knee practical office orthopedics accessmedicine. The exact role that the meniscus cartilages play in the function of the knee is poorly understood, but they do not act as a cushion between the femur and tibia, as many of us were taught see sidebar. Apr 22, 2006 this retrospective study was conducted to analyse the reliability of clinical diagnosis in meniscal tear injuries. The last bone we need to add if we are building a knee is the patella. Meniscal tear injury cambridge uk knee joint injury. To study mr findings of meniscal tears with discoid lateral menisci dlms and to evaluate the incidence and accuracy of mri compared to arthroscopical surgery. Robert laprade details the specifics on how to read an mri of a medial meniscus tear. Management of degenerative meniscal tears and the role of. A guide to evaluation and reporting is a wellwritten, uptodate book covering all imaging aspects of magnetic resonance mr imaging of the knee joint. The goal of this article is to summarize the literature about the diagnosis of meniscal tears on mri including the normal appearance of the meniscus and the appearance of the various types of meniscal tears.
Meniscal tear arthroscopic view of tear regenerated meniscus 6. It is well established that meniscal damage predisposes the adjacent articular cartilage to increased axial and sheer stress, resulting in early degenerative osteoarthritis. This tear begins at the free edge of the meniscus and extends towards the. The subsequent medial meniscus tear rate requiring removal was 16% in the study group versus 6% in the control group. Work with your doctor to plan a rehabilitation rehab program that helps you regain as much. The sensitivity of mri for detecting meniscal tears at the anterior horn, body, posterior horn and overall.
Clinical diagnostic tests versus mri diagnosis of acl tears. The value of standard radiography is extremely limited for the assessment of meniscal injuries but may be indicated to obtain a. Computed tomography scan ct scan computed tomography scan ct or cat scan is a noninvasive diagnostic imaging procedure that uses a combination of special xray equipment and sophisticated computer technology to produce crosssectional images often called slices, both horizontally and vertically, of the body. Evaluation of traumatic knee joint injuries with mri. The majority of missed meniscus tears on mri affected the peripheral posterior horns. After suffering a meniscus tear, your physician will usually order knee xrays to make sure there is no damage to your bones. Nov 01, 2018 sagittal mri of the knee in a 44 year old male following a twisting injury reveals hyperintense bright signal in keeping with fluid, extending to the undersurface of the posterior horn of the medial meniscus, in keeping with a tear. How well the knee will heal and whether surgery will be needed depends in large part on the type of tear see figure in appendix and how bad the tear is.
All anatomical descriptions were clearly illustrated by mri, arthroscopy, andor drawings. You may also need an mri magnetic resonance imaging scan, which allows a more detailed evaluation of knee cartilage. Meniscal tears are one of the most frequently reported injuries to the knee joint. Most meniscal injuries, anterior cruciate ligament and lateral collateral. It is also common for the meniscus to be damaged in association with injuries to the anterior cruciate ligament.
41 412 935 572 402 259 998 979 1369 650 697 455 246 147 1414 34 1201 314 805 567 232 764 670 532 761 439 618 1080 942