The “Floating” Meniscus: MRI in Knee Trauma and Implications for Surgery

Abstract

The presence of a floating meniscus on MRI is a result of significant trauma to the knee leading to meniscal avulsion and is often associated with significant ligamentous injury. Alerting the surgeon to the presence of a meniscal avulsion facilitates appropriate surgical planning with meniscal reattachment to the tibial plateau.

MRI features of the anterolateral ligament of the knee

“…Dodds et al [5] showed its complex femoral origin with a fan-like blending of fibers without a distinct area of direct bony attachment, contested by some authors to be anterior [2] or posterior [5] to the femoral epicondyle, or even presenting connections with the popliteal tendon origin [1]. Although some authors illustrated a clear meniscal attachment [2,4,12], it may not be easily differentiated from the lateral inferior geniculate artery and vein [1], meniscocapsular ligaments [13,14], and iliotibial tract fibers [3,8]. Vincent et al showed in a cadaveric dissection study that the ALL has a close relationship to the lateral meniscus next to the junction of its anterior and middle thirds, but it was impossible to macroscopically assess a meniscal insertion [1].…”

Kinematic change of the meniscus and the tibiofemoral joint space in asymptomatic volunteers using a wide bore 3T closed MRI system

“…In one study [11], the presence of fluid signal intensity completely surrounding one or both horns of either meniscus suggested meniscal avulsion, especially with a fluid signal intensity thicker than 2-3 mm in the craniocaudal dimension beneath the meniscal surface. The largest fluid-filled gap measured beneath the PHMM here was 2.23 mm (mean size 1.34 mm).…”

“…The distance of mediolateral meniscal movement was calculated as the absolute value of extrusion minus the value of intrusion for each meniscus. In the sagittal images, any fluid-filled gap overlying the meniscal inferior or superior surface entirely was considered meniscal floating [11]. A meniscal flounce was defined as a folding of the free edge of the meniscus [12] on the sagittal 2D FSE T2-weighted image and was evaluated and agreed upon by two radiologists with 6 and 15 years of experience in musculoskeletal MRI.…”

Should Brackets be Removed Before Magnetic Resonance Imaging?

“…Beyin ve santral sinir sistemi hastalıkları: 18 Sporcu yaralanmaları 19 Menisküs teşhisi 20 Bel fıtığı teşhisi 21 Nörolojik rahatsızlıklar 22 TME rahatsızlıkları 23 Epilepsi vb.…”