The Finochietto Sign as a Pathognomonic Finding of Ramp Lesion of the Medial Meniscus

Abstract

Ramp lesions are considered hidden injuries of the medial meniscus and are very difficult to diagnose. The Finochietto jump sign is a very specific finding that could be considered pathognomonic regarding ramp lesions. This sign consists of a sudden jerk that appears when the free edge of the posterior horn of the medial meniscus is dislocated anteriorly due to the medial condyle interposition when an anterior drawer test is performed on a knee with a ramp lesion, especially when it is associated with an anterior cruciate ligament tear. In this technical note, the Finochietto sign is described clinically, is correlated with its exploration under anesthesia, and is described for the first time under arthroscopic examination in the case of a ramp lesion, in which this finding can help to the diagnosis when present, especially when associated with anterior cruciate ligament tears.

Ramp Lesion Subtypes: Prevalence, Imaging, and Arthroscopic Findings in 2156 Anterior Cruciate Ligament Reconstructions

“…In this study, a tear was labeled a “ramp lesion” if the longitudinal tear involved the peripheral attachment of the posterior horn of the medial meniscus (meniscocapsular junction or red-red zone) and extended longitudinally for ≤3 cm. Second, any ramp lesions were classified into 1 of the 5 subtypes using the previously published classification system 2,14,15,25,26,30,32 (Figure 2). The length of the tear (ie, longitudinal extension) was also recorded in increments of 0.5 cm (Figure 3).…”

“…In 2016, Thaunat et al 30 described a novel classification system that divided ramp lesions into 5 subtypes: meniscocapsular lesion, partial superior lesion, partial inferior lesion or hidden type, complete tear, and double tear. 14,15 We conducted this retrospective study on prospectively collected data to further our knowledge about ramp lesions and to describe the subtype features of ramp lesions. The objectives of this study were (1) to determine the prevalence of ramp lesion subtypes in a large series of patients undergoing arthroscopic ACL reconstruction (ACLR) and (2) to describe the characteristics of ramp lesion subtypes based on imaging and diagnostic arthroscopy.…”

Anterior Cruciate Ligament Revision Surgery Associated to Lateral Collateral and Anterolateral Ligaments Reconstruction With Single Achilles Tendon Allograft and Single Femoral Tunnel

“…The articular lesions are addressed in a routine arthroscopic exploration of the knee. The arthroscopic Finochietto jump sign, 11 which consists on an anterior subluxation of the posterior horn of the medial meniscus, and the posteromedial compartment 12 of the knee is checked to diagnose ramp lesions. A varus force is applied to check the increase of length of the femorotibial space arthroscopically.…”

Ramp lesion of the medial meniscus

“…Although not usually applied in clinics, Finochietto sign 35 can be positive in some patients with MRL. 36 It is a highly specific sign of meniscal posterior longitudinal tear. It may appear useful in the diagnosis of MRL in the outpatient department, but one must keep in mind that patients often complain of discomfort or pain during and after performing the manoeuvre.…”