Meniscal Ossicle in the Lateral Meniscus: An Unusual Variant of a Rare Entity

Yen, Philip; Hunter, John C.; Escobedo, Eva M.

doi:10.2484/rcr.v4i2.289

Cited by 7 publications

(14 citation statements)

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“…Histologically, ossification demonstrates lameller and cancellous bone with fatty bone marrow surrounded by cortex, which is covered by hyaline cartilage. 1e3, 7,8 Many theories have been postulated regarding the aetiology of ossifications. They may be vestigial structures, as they are common in rodents, and domestic cats.…”

Section: Discussionmentioning

confidence: 99%

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Ossification of the discoid meniscus: A case report

Duran

Çavuşoğlu

Kocadal

2014

Journal of Clinical Orthopaedics and Trauma

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Discoid OssificationMagnetic resonance imaging a b s t r a c t Meniscal ossification, or bone formation within the substance of the meniscus, is a rare entity. Magnetic resonance imaging allows the unequivocal diagnosis of a meniscal ossification. We aimed to present a case of discoid meniscal ossification, which is quite rare, with the emphasis on imaging findings.Copyright © 2014, Delhi Orthopaedic Association. All rights reserved. IntroductionMeniscal ossification is mature lameller and cancellous bone containing fatty bone marrow surrounded by hyaline cartilage within the substance of meniscus. 1e3 Discoid meniscal ossification is exceedingly rare. Imaging is required to confirm the diagnosis and to assess the meniscal integrity. Standard radiographs and magnetic resonance imaging (MRI) have been reported useful in the diagnosis of meniscal ossification. 4 We aimed to present a case of discoid meniscal ossification with the emphasis on imaging findings. Case reportA 42-year-old women presented with pain in the left knee joint lasting for nine months. The pain was intermitten in nature. There was no history of recent trauma or any other relevant past history. Physical examination showed a moderately painful swollen joint without any restriction of movement. Upon admission, no pathological findings were found at the patellofemoral joint or periarticular ligamentous structures on the physical examination. The plain radiographs obtained a wedge-shaped, like the meniscus, bony fragment at the lateral side of the knee joint (Fig. 1). MR imaging of this knee was performed to evaluate the ossific density. A well-defined lesion which was seen in the discoid lateral meniscus was isointense to the bone marrow on all pulse sequences, with a complete hypointense rim (Fig. 2aed). The lesion size was 36*30*6.5 mm. This was reported as a meniscal ossification. The articular cartilage was also normal. Mild synovial effusion was detected. In addition, a simple cyst of the proximal fibula was detected. Available online at www.sciencedirect.com ScienceDirect j o urna l h om epag e: www.elsevier.com /locate/jcot j o u r n a l o f c l i n i c a l o r t h o p a e d i c s a n d t r a u m a 5 ( 2 0 1 4 ) 2 7 0 e2 7 3http://dx

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Section: Discussionmentioning

confidence: 99%

“…1,8,12 There is no concordance regarding treatment of meniscal ossification. However, most authors advise conservative treatment in the first instance, but arthroscopy and meniscectomy may be a choice of treatment for persistent symptoms.…”

Section: Discussionmentioning

confidence: 99%

Ossification of the discoid meniscus: A case report

Duran

Çavuşoğlu

Kocadal

2014

Journal of Clinical Orthopaedics and Trauma

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“…(2)(3)(4) Most cases involve the posterior horn of the medial meniscus, with fewer reports of involvement in the lateral meniscus and anterior horns. (2,3,5) Meniscal ossicles are defined as mature bone embedded within the substance of the meniscus. (5,6) Histologically, ossicles are seen as lamellar and cancellous bone with fatty bone marrow, and they are surrounded by meniscal fibrocartilage.…”

Section: Discussionmentioning

confidence: 99%

“…(2,3,5) Meniscal ossicles are defined as mature bone embedded within the substance of the meniscus. (5,6) Histologically, ossicles are seen as lamellar and cancellous bone with fatty bone marrow, and they are surrounded by meniscal fibrocartilage. (1,6,7) Several authors have reported foci of increased vascularisation, fibroblastic proliferation and even osteogenic activity.…”

Section: Discussionmentioning

confidence: 99%

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Clinics in diagnostic imaging (144)

Sl¹,

Lee²,

Forster³

et al. 2013

SMedJ

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A 35-year-old female patient with previous left knee anterior cruciate ligament repair for a skiing injury presented six years later with a traumatic lateral patellar subluxation. Radiographs and magnetic resonance imaging of her left knee joint showed an ossific structure in the region of the lateral meniscus. This was diagnosed as a meniscal ossicle and confirmed during successful arthroscopic excision. The imaging features of meniscal ossicles are reported.

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Diagnostic and therapeutic approach to meniscal ossification: a systematic review

Ververidis

Keskinis

Paraskevopoulos

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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PurposeThe purpose of this study was to systematically review case reports and case series about meniscal ossicle, to summarize existing evidence. Specifically, to identify the etiology, demographic characteristics, localization, clinical features, diagnostic procedures and treatment options of this rare entity. Although, case reports/ series are of low level of evidence, a systematic review of such studies can provide and help us to gain a better understanding and awareness of meniscal ossicle. MethodsTwo authors searched three online databases (MEDLINE, SCOPUS and GOOGLE SCHOLAR) from inception until March 2020 for the literature on meniscal ossicle. Inclusion criteria included case series, case reports and case‐based reviews, available in full‐text version, in English and that concern humans. Reports published in languages other than English were excluded, as well as articles with no electronic full text availability. Case reports using the term “meniscal ossicle” to describe an acute avulsion fracture of the tibial root of the meniscus, were also excluded. ResultsOf 453 initial studies, 38 studies satisfied inclusion criteria. In total 169 patients were included of whom 107 (63%) were males and 62 (37%) were females. Mean age was 44 years (range 12–87). According to Magnetic resonance imaging findings, in 144 knees (86%) the ossicle was localized at the posterior root or horn of the medial meniscus. 60% of the patients had a history of trauma. The predominant symptom in 87% of patients was knee pain. In all patients was detected an intra‐articular density structure in computed radiography. 76% had associated meniscal tear, 61% had intraarticular cartilage loss, 34% meniscal extrusion and 28% anterior cruciate ligament injury. Treatment modalities included conservative regimen in 40 patients, while 59 patients underwent surgical excision. ConclusionThe most possible etiology of meniscal ossicle is posttraumatic heterotopic ossification and small occult bony avulsion fracture. It is commonly observed in individuals complaining about knee pain with history of antecedent trauma. The presence of a meniscal ossicle should alert the physician to the high likelihood of the patient having an associated meniscal tear, articular cartilage loss, ACL injury or meniscal extrusion. Along with the meniscal ossicle, the associated meniscal tear should be treated as well.

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Meniscal Ossicle in the Lateral Meniscus: An Unusual Variant of a Rare Entity

Abstract: Meniscal ossicles are rare entities of the knee usually involving the medial meniscus. Lateral meniscal ossicles are exceedingly rare. We present a case of a lateral meniscal ossicle found incidentally after trauma. The etiology and characteristic findings on imaging are discussed.

Cited by 7 publications

References 8 publications

Ossification of the discoid meniscus: A case report

Ossification of the discoid meniscus: A case report

Clinics in diagnostic imaging (144)

Diagnostic and therapeutic approach to meniscal ossification: a systematic review

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