Bucket-handle tears of the meniscus: appearance at CT.

Manco, Lawrence G.; Berlow, Michael E.; Czajka, Jaddy; Alfred, Richard H.

doi:10.1148/radiology.168.3.3406401

Cited by 9 publications

(3 citation statements)

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“…Similar studies have been performed by Boos and Bugyi [4] and Holzach et al [12]. The same studies with CT and MRI were published by Manco et al [19], Hermann and Beltran [11], Verdonk et al [32], Kelly et al [15], Burstein et al. [7], Victor et al [33], and Boeve et al [3].…”

Section: Introductionsupporting

confidence: 71%

Interobserver variance in diagnostic arthroscopy of the knee

Kampen

Malefijt

Jerosch

et al. 1998

Knee Surgery, Sports Traumatology, Arthroscopy

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The diagnostic interindividual variance of 91 German and Dutch arthroscopists has been assessed by the Kappa Cohen interobserver variation analysis using a videotape with three complete knee arthroscopies with different pathologies. Non-pathological conditions show a moderate to excellent interobserver correlation, whereas pathological changes often show very little correlation, especially the synovial membrane of the suprapatellar recess, the cartilage of the femuropatellar groove, and the posterior cruciate ligament. The patella alignment also shows a high interobserver variability. There are no apparent differences between German and Dutch arthroscopists. When comparing arthroscopic findings with other imaging techniques the above results should be taken into account because the use of arthroscopy as golden standard is challenged. Furthermore, these results will influence the meaningfulness of medical expert witness based only on pictures. Also the medical cost balance based on arthroscopic findings has to take into account that a wrong diagnosis is possible and therefore charged wrong.

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Section: Introductionsupporting

confidence: 71%

Interobserver variance in diagnostic arthroscopy of the knee

Kampen

Malefijt

Jerosch

et al. 1998

Knee Surgery, Sports Traumatology, Arthroscopy

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show abstract

“…Manco and associates [11] utilized computed tomographic (CT) scanning for the evaluation of bucket-handle meniscal tears and described two patterns. The first was present in 69.4% of their cases and revealed a disruption of the posterior attachment of the central fragment to the meniscus with rotation and displacement of the fragment through the intercondylar notch until it lay in the vicinity of the infrapatellar fat pad.…”

Section: Discussionmentioning

confidence: 99%

The flipped meniscus sign

et al. 1993

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Meniscal fragments may be difficult to detect on magnetic resonance (MR) imaging and yet are clinically significant. This paper describes and illustrates the MR appearance of an easily overlooked meniscal fragment. Ten knees, each appearing to show an abnormally large anterior meniscal horn (8 mm or more in height) were prospectively identified on MR images. In each case demonstrable large tears of the ipsilateral posterior horns were present (same meniscus as had large anterior horns). The lateral meniscus was involved in nine cases and the medial in one. Two of the ten patients imaged had surgically proven bucket-handle meniscal tears as well as meniscal fragments overlying the ipsilateral anterior horn. In one case previous MR imaging at our institution had demonstrated the affected anterior horn to be of normal caliber. The striking MR appearance of an abnormally enlarged anterior meniscal horn in association with a tear of the ipsilateral posterior horn suggests the presence of a meniscal fragment or of a posteriorly detached bucket-handle tear of the posterior horn of the meniscus.

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“…While some single case reports have presented the finding of a bucket handle meniscal tear on CT, the sensitivity and specificity of CT scans for this type of injury are not well established [ 10 ]. Most studies on the diagnostic accuracy of CT and MRI for meniscal injuries are from the 1980s and are based on outdated scanners [ 11 , 12 , 13 ]. A better understanding of the sensitivity and specificity of CT scans for detecting dislocated bucket handle meniscal tears could have significant implications for the evaluation and management of acute knee injuries, potentially reducing the need for more invasive diagnostic procedures and leading to earlier interventions and improved patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy of 128-Slice Single-Source CT for the Detection of Dislocated Bucket Handle Meniscal Tears in the Setting of an Acute Knee Trauma—Correlation with MRI and Arthroscopy

et al. 2023

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(1) Background: Meniscal tears are amongst the most common knee injuries. Dislocated bucket handle meniscal tears in particular should receive early intervention. The purpose of this study was to evaluate the diagnostic performance of CT in detecting dislocated bucket handle meniscal tears compared with the gold-standard MRI and arthroscopy. (2) Methods: Retrospectively, 96 consecutive patients underwent clinically indicated CT of the knee for suspected acute traumatic knee injuries (standard study protocol, 120 kV, 90 mAs). Inclusion criteria were the absence of an acute fracture on CT and a timely MRI (<6 months). Corresponding arthroscopy was assessed. Two experienced musculoskeletal radiologists analyzed the images for dislocated bucket handle meniscal tears, associated signs thereof (double posterior cruciate ligament sign, double delta sign, disproportional posterior horn sign), and subjective diagnostic confidence on a 5-point-Likert scale (1 = ‘non-diagnostic image quality’, 5 = ‘very confident’). (3) Results: Dislocated bucket handle meniscal tears were detected on CT by standard three-plane bone kernel reconstructions with a sensitivity of 90.7% and a specificity of 99.3% by transferring the knowledge of established MRI signs. The additional use of soft-tissue kernel reconstructions in three planes increased the sensitivity by 4.0% to 94.7%, specificity to 100%, inter-rater agreement to 1.0, and the diagnostic confidence of both readers improved to a median 4/5 (‘confident’) in both readers. (4) Conclusions: Trauma CT scan of the knee with three-plane soft-tissue reconstructions delivers the potential for the detection of dislocated bucket handle meniscal tears with very high diagnostic accuracy.

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Bucket-handle tears of the meniscus: appearance at CT.

Cited by 9 publications

References 0 publications

Interobserver variance in diagnostic arthroscopy of the knee

Interobserver variance in diagnostic arthroscopy of the knee

The flipped meniscus sign

Diagnostic Accuracy of 128-Slice Single-Source CT for the Detection of Dislocated Bucket Handle Meniscal Tears in the Setting of an Acute Knee Trauma—Correlation with MRI and Arthroscopy

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