Meniscus Imaging

Abstract

As the therapeutic options for the treatment of meniscal lesions evolve, so do the challenges in both preoperative and postoperative imaging of the meniscus. Ideally, an imaging modality should accurately depict the meniscus and any meniscal lesions in such a way that the best treatment option can be chosen. It should also be able to depict the treated area, accurately assess the follow-up of treatment, and differentiate the findings associated with the treatment from recurrent lesions. At this moment magnetic resonance (MR) is the imaging modality of choice for the virgin meniscus, the operated meniscus, and the transplanted meniscus. In all these situations, unenhanced MR imaging accurately displays the meniscus and the possible lesions. Only in patients with sutured menisci can the performance of MR be improved by intra-articular contrast administration. Computed tomographic arthrography has a similar accuracy as MR imaging for the detection of meniscal lesion, and it is especially valuable for the evaluation of menisci in the presence of orthopaedic hardware. It remains, however, an invasive technique that requires ionizing radiation.

Arthroscopic Meniscectomy for Medial Meniscus Horizontal Cleavage Tears in Patients under Age 45

“…A HCT divides the meniscus into superior and inferior leaves resembling a fish mouth or it extends to the superior or inferior articular surface, developing into a superior or inferior flap tear123). In the current study, we investigated if any differences would exist between type 1 and type 2 HCTs and if classification would be helpful in determining the treatment plan and prognosis.…”

Meniscus pathology, osteoarthritis and the treatment controversy

“…This sequence also allows other crucial joint structures, including cartilage, subchondral bone, ligaments and joint fluid to be imaged effectively ( Figure 2). 37,39 The sensitivity and specificity of detecting a meniscal tear by MRI are both reported to be in the range of 82-96%, and the utilization of the 'twoslice touch' rule (the tear must be seen on at least two adjacent images) in routine bidimensional MRI favours high specificity. 40,41 Key points ■ Meniscus damage is highly prevalent in middle-aged and elderly people in the general population ■ Most meniscal tears do not cause knee pain ■ Meniscus damage is almost always present in knees with radiographic osteoarthritis (OA) ■ Meniscus damage might lead to OA and OA might lead to meniscus damage ■ Conservative management (patient education, weight reduction and/or physical exercise therapy), should always be the first treatment of choice for patients with knee pain and degenerative meniscus damage ■ Patients who experience painful catching or locking of their knee due to an unstable meniscal tear might require surgical treatment Detailed reviews of meniscus MRI techniques, including descriptions of the common diffi culties in diagnosis of meniscus pathology, are available elsewhere.…”

“…[31][32][33][34][35][36] Imaging of meniscus pathologies MRI can be used to view the menisci and detect pathol ogy; the use of a dedicated knee coil is essential, slice thickness should be no more than 3 mm, and both sagit tal and coronal images are needed. 37 Axial MRI has also been shown to be useful for the detection and charac terisation of meniscus pathology. 38 A fast (or turbo) spin echo in termediateweighted fat suppressed sequence with a time of echo of approximately 35 ms and a long repetition time (in order to achieve maximum contrast tonoise ratio) is the preferred choice for diagnosis of meniscus pathology.…”

Magnetic Resonance Imaging of the Postoperative Meniscus

“…25). 146 This hyperintensity tends to diminish over the years as the scaffold matures, but never reaches the low signal of normal fibrocartilage.…”