Magnetic resonance imaging (MRI) of the knee: Identification of difficult-to-diagnose meniscal lesions

Abstract

This article characterizes common meniscal pathologies, reviews magnetic resonance imaging (MRI) diagnostic criteria for meniscal tears, and identifies difficult-to-detect tears and fragments and the best MRI sequences and practices for recognizing these lesions. These difficult-to-diagnose meniscal lesions that radiologists should consider include tears, meniscocapsular separation lesions, and displaced meniscal fragments. Meniscus tears are either vertical, which are generally associated with traumatic injury, horizontal, which are associated with degenerative injury, or combinations of both. MRI has a high sensitivity for tears but not for fragments; MRI performance is also better for medial than lateral meniscal lesions. Fragment detection can be improved by recognizing signs secondary to migration, especially signs of epiphyseal irritation and mechanical impingement. Radial and peripheral tears, as well as those close to the posterior horn insertion, have been traditionally difficult to detect, but improvements in arthroscopic knowledge, identification of common lesion patterns, and selection of the proper MRI sequence and plane for each lesion type mean that, when properly used, MRI is an invaluable tool in detecting all types of meniscal tears.

Diagnostic Performance of Magnetic Resonance Imaging for Detecting Meniscal Ramp Lesions in Patients With Anterior Cruciate Ligament Tears: A Systematic Review and Meta-analysis

“…Meniscal ramp lesions are defined as a tear, disruption, or separation of the peripheral meniscocapsular attachments of the posterior horn of the medial meniscus (MMPH) 3,20 and present as superior meniscocapsular ligament tear, inferior meniscotibial ligament tear, or both. 10,11 Meniscal ramp lesions occur after traumatic knee injuries, especially anterior cruciate ligament (ACL) tear, or in an ACL-deficient knee.…”

Deep Learning-Based MRI in Diagnosis of Fracture of Tibial Plateau Combined with Meniscus Injury

“…where T represents the Kaiser-Bessel interpolation matrix, R represents the Fourier matrix, U represents the diagonal matrix, and RUR * represents the deconvolution result. e following equation is then obtained by combining equations ( 4) and (8).…”

“…Magnetic resonance imaging (MRI) has high resolution for the soft tissue of the knee joint [7] and has high specificity and sensitivity for the diagnosis of injury sites. More importantly, MRI examination is noninvasive with low radiation [8,9], so MRI is widely used to diagnose meniscus injuries in clinical practice.…”

Deep Learning-Based Magnetic Resonance Imaging Image Features for Diagnosis of Anterior Cruciate Ligament Injury

“…Clinically, complete tears and partial tears are often taken as the basis for judging ACL damage [5]. All in all, the early and correct diagnosis after ACL injury is of great significance for the choice of clinical treatment plan and prognosis [6,7]. e commonly used methods for diagnosing ACL injury are roughly classified into three categories, clinical stability examinations, such as anterior drawer test and axis shift test, imaging examinations such as ultrasound diagnosis, CT diagnosis, and MRI diagnosis, and arthroscopy [8].…”

“…Clinically, complete tears and partial tears are often taken as the basis for judging ACL damage [ 5 ]. All in all, the early and correct diagnosis after ACL injury is of great significance for the choice of clinical treatment plan and prognosis [ 6 , 7 ].…”