Magnetic Resonance Imaging of the Meniscus

Rosas, Humberto G.

doi:10.1016/j.mric.2014.07.002

Cited by 23 publications

(17 citation statements)

References 61 publications

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“…Sensitivity is shown to be related to the location and tear pattern for the lateral meniscus, with peripheral longitudinal tears involving the posterior third of the meniscus demonstrating the lowest sensitivities. 10 False negatives are more common in the lateral meniscus as well, especially with tears of the posterior horn or if less than one-third of the meniscus is involved. 11 High signal intensity in the body of the meniscus in MRI is a wellestablished criterion for diagnosing a meniscal tear or degeneration.…”

Section: Discussionmentioning

confidence: 99%

Intraobserver and Interobserver Agreement of Magnetic Resonance Imaging for Reparability of Peripheral Meniscal Tears: What Criteria Really Matter?

et al. 2016

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The objective of the study was the determination of the intra- and interobserver agreement of three magnetic resonance imaging (MRI) criteria for reparability: a peripheral rim smaller than 4 mm, a tear longer than 10 mm, and homogenous aspect of meniscal tissue. In two rounds with an interval of at least 6 weeks, three orthopedic surgeons and three musculoskeletal radiologists studied the preoperative MRI scans of 63 patients with a longitudinal full-thickness medial or lateral meniscal tear. All patients had an arthroscopic meniscal repair. The blinded images were evaluated measuring the tear length and rim width and meniscal aspect was classified. Agreement was calculated using the linear-weighted kappa coefficient () and the intraclass correlation coefficient (ICC). Examiner agreement strength was defined according to the guidelines of Landis and Koch. Intraobserver agreement was poor to good (, 0.12-0.72) for the classification of the meniscal aspect and decreased in lateral meniscal tears. The interobserver agreement for meniscal aspect was mainly poor to fair (, 0.09-0.53). The intraobserver reliability for measurement of the length of the meniscal tear was moderate to excellent (ICC, 0.51-0.80) for all observers in both rounds and moderate to good (ICC, 0.59-0.73) for measurement of the peripheral rim width. The interobserver agreement on tear length and rim width was moderate in both rounds (ICC, 0.58 and 0.50 in round 1; 0.50 and 0.50 in round 2, respectively). Tear length and rim width are the only two measurements with moderate to good agreement. However, these measurements do not predict reparability of longitudinal meniscal tears on MRI images.

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Section: Discussionmentioning

confidence: 99%

Intraobserver and Interobserver Agreement of Magnetic Resonance Imaging for Reparability of Peripheral Meniscal Tears: What Criteria Really Matter?

et al. 2016

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“…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. [41][42][43] Common adult meniscus pathologies Traumatic meniscal tears Most healthcare professionals and lay people associ ate meniscal tears with acute sports injury. Acute knee trauma is a major cause of internal injuries to the knee, including the menisci, cartilage and/or cruciate liga ments.…”

Section: Menisci Anatomy and Functionmentioning

confidence: 99%

Meniscus pathology, osteoarthritis and the treatment controversy

et al. 2012

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The menisci are internal structures that are of central importance for a healthy knee joint; they have a key role in the structural progression of knee osteoarthritis (OA), and the risk of the disease dramatically increases if they are damaged by injury or degenerative processes. Meniscus damage might be considered a signifying feature of incipient OA in middle-aged and elderly people. As approximately every third knee of people in these groups has a damaged meniscus, tears are common incidental findings of knee MRI. However, as most tears do not cause symptoms, careful clinical evaluation is required to determine if a damaged meniscus is likely to directly impact a patient's symptoms. Conservative management of patients with knee pain and a degenerative meniscal tear should be considered as a first-line therapy before surgical treatment is contemplated. Patients with mechanical interference of joint movements, such as painful catching or locking, might need surgical treatment with meniscal repair if possible. In a subset of patients, meniscal resection might relieve pain and other symptoms that potentially originate directly from the torn meniscus. However, the possibility of an increased risk of OA if functional meniscal tissue is removed cannot be overlooked.

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“…In contrast, the lateral meniscus maintains a relatively constant width with anterior and posterior horns being similar in size. 16 Functionally, the menisci increase stability of the femorotibial articulation, distribute axial load, absorb shock, and provide lubrication and nutrition to the joint. Collagen bundles are primarily responsible for the tensile strength of menisci, with longitudinal circumferential orientation of primary meniscal collagen bundles functioning to transfer vertical compressive load into circumferential "hoop stresses."…”

Section: Normal Meniscusmentioning

confidence: 99%

Diagnosing Meniscal Pathology and Understanding How to Evaluate a Postoperative Meniscus Based on the Operative Procedure

et al. 2018

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Magnetic resonance imaging (MRI) represents the preferred noninvasive imaging technique to diagnose meniscal pathology in the pre- and postoperative setting. Furthermore, characterization of meniscal tissue MR properties has been possible by the development of advanced MRI techniques. Suspected meniscal tears are a frequent indication for MRI and the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) classification system has been developed to facilitate accurate and uniform reporting of such meniscal tears. Partial meniscectomy and meniscal suture repair are among the commonly performed procedures and several signs have been described to detect postoperative recurrent tears on MRI. Other techniques that have proven useful for meniscal assessment are ultrasound (US) and computed tomography (CT) arthrography. In recent years, US is being increasingly used in the selective assessment of some meniscal pathology such as tears, parameniscal cysts and meniscal extrusion as it is a relatively inexpensive, accessible, and safe technique. CT arthrography has been advocated as an acceptable alternative in patients with contraindications for MRI, with comparable diagnostic performance.

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Magnetic Resonance Imaging of the Meniscus

Cited by 23 publications

References 61 publications

Intraobserver and Interobserver Agreement of Magnetic Resonance Imaging for Reparability of Peripheral Meniscal Tears: What Criteria Really Matter?

Intraobserver and Interobserver Agreement of Magnetic Resonance Imaging for Reparability of Peripheral Meniscal Tears: What Criteria Really Matter?

Meniscus pathology, osteoarthritis and the treatment controversy

Diagnosing Meniscal Pathology and Understanding How to Evaluate a Postoperative Meniscus Based on the Operative Procedure

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