Calcification, decalcification, and ossification

Jones, R. Watson; Roberts, Richard E.

doi:10.1002/bjs.1800218312

Cited by 96 publications

(10 citation statements)

References 42 publications

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“…The meniscal ossicle was first described in the literature in the 1930s by multiple authors. [4][5][6] and currently the most popular theory of origin is that the ossicle is the result of a prior single or repetitive traumatic event. 3,9 Numerous case reports have been published on this topic, while a limited number of studies have been performed with the largest being a case series by Mohankumar et al in which they assessed 65 knee MRI examinations and described the location of the ossicle within the meniscus as well as associated imaging findings of the knee.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 First reports of meniscal ossicles appeared in the literature in the 1930s. [4][5][6] Prior to the advent of magnetic resonance imaging (MRI), meniscal ossicles were difficult to identify, and there were pitfalls of using radiography alone, as an ossicle could be misidentified as a loose body. 2 However, the presence of a meniscal ossicle can be identified on MRI as a well-defined focus of signal intensity within the substance of the meniscus matching that of the adjacent bone on all sequences.…”

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confidence: 99%

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Understanding the Implications of the Meniscal Ossicle: Patient Presentation, Treatment, and Outcomes

et al. 2019

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The meniscal ossicle is observed in clinical practice, yet there currently is limited information on its potential clinical significance. The purpose of this study was to assess the clinical presentation, imaging findings, and clinical treatment and outcomes of a series of patients identified as having a meniscal ossicle. An institutional database was reviewed to identify knees with a meniscal ossicle. Clinical presentation, magnetic resonance imaging (MRI), treatment, and outcomes were analyzed. Radiographs were graded using Kellgren–Lawrence (KL) scores. MRIs were reviewed for the presence and location of meniscal ossicles and additional knee pathology. Knee arthroplasty rates were recorded with the remaining patients contacted to obtain final International Knee Documentation Committee (IKDC) and Tegner's scores. Failure was defined as conversion to arthroplasty or failing IKDC score (< 75.4). Forty-five meniscal ossicles in 45 patients (26 males and 19 females) with a mean age of 51 years (standard deviation [SD] = 19.0) were included. Pain was the most common presenting symptom (89%). Forty-two patients (93%) had an associated meniscus root tear on MRI. Eighteen percent of patients that did not have an ossicle on initial imaging subsequently developed an ossicle. Mean KL grades progressed significantly from baseline of 1.84 (SD = 1.0) to 2.55 (SD = 0.93 p < 0.01) on final follow-up. Thirty-nine percent of baseline radiographs showed KL grades of less than 2 compared with only 15% of follow-up radiographs (p = 0.04). Mean IKDC score obtained for patients ≤ 60 at an average follow-up of 3.1 years (SD = 3.2) was 65.2 (SD = 19.0). Eight out of 45 patients (18%) had progressed to total knee arthroplasty (TKA) by latest available follow-up. Sixty-two percent of patients met failure criteria at latest available follow-up. The meniscal ossicle is most commonly found in the posterior horn or root of the medial meniscus and is highly suggestive to be sequelae of a posterior root tear. Therefore, the presence of a meniscal ossicle should alert the orthopaedic surgeon to the high likelihood of the patient having a meniscus root tear. These patients have shown to have poor clinical outcomes and worsening arthritis.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Understanding the Implications of the Meniscal Ossicle: Patient Presentation, Treatment, and Outcomes

et al. 2019

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“…Firstly, some consider it to be a degenerative phenomenon where areas of mucoid degeneration are replaced by bone [ 9 ]. Secondly some suggest it as posttraumatic sequelae with development of heterotopic ossification [ 2 , 5 – 7 ]. Third theory proposes it to be a vestigial structure based on its presence in animal species like domestic cats, rodents, and Bengal tigers [ 1 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Radiological differentiation can be made from osteochondral loose bodies and chondrocalcinosis by its ossified appearance and its typical location within the meniscus. Correct diagnosis is required so that unnecessary surgery is avoided and protracted search of free fragment is not carried out [ 5 , 6 ]. We present a case of 2 ossicles in the medial meniscus with emphasis on MRI and CT findings.…”

Section: Introductionmentioning

confidence: 99%

Double Meniscal Ossicle, the First Description: CT and MRI Findings—Different Etiologies

Kumar¹,

Dey²,

Mittal³

et al. 2015

Case Reports in Radiology

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We present a case of 2 ossicles in the medial meniscus with emphasis on MRI and CT findings. Meniscal ossicle is a rare entity and is quite uncommon on the medial side. By showing the typical signal characteristics and intrameniscal location, MRI can be helpful in distinguishing this from other more clinically significant abnormalities. It should be kept as differential from synovial chondromatosis or sesamoid bones like fabella as management is different for all of these entities.

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“…3,12,14 Red, brown, blue, or purple skin discoloration may be present when cavernous hemangiomas develop in close proximity to the overlying epidermis; this discoloration must be differentiated from that of varicose veins. 14,19,20 Currently, magnetic resonance imaging (MRI) is considered the most accurate modality for diagnosing and delineating the extent and consistency of deep soft-tissue tumors. On palpation, cavernous hemangiomas may be either fixed or movable and may be soft and spongy or indurated.…”

Section: Hemangioma Of the Footmentioning

confidence: 99%