MR Imaging of the Hypermobile Lateral Meniscus of the Knee: A Case Report

Nair, R. V.; Dubey, Niraj

doi:10.5644/ama2006-124.261

Cited by 8 publications

(13 citation statements)

References 7 publications

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“…Since some studies have reported that the widening of the popliteal hiatus on the MRI leads to a hypermobile lateral meniscus, the opening of the hiatus was also added as an item of evaluation in the current study [ 11 , 16 ]. On proton density-weighted sagittal MRI, Type 1 was defined as no clear high-signal hiatus; Type 2 was defined as a clear high-signal hiatus with a maximum width of 1 mm or less; and Type 3 was defined as a clear high-signal hiatus with a maximum width of 1 mm or more ( Figure 2 ).…”

Section: Methodsmentioning

confidence: 99%

Preoperative Magnetic Resonance Imaging as a Diagnostic Aid for Hypermobile Lateral Meniscus

Toyooka

Shimazaki²,

Masuda

et al. 2021

Diagnostics

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Background: Hypermobile lateral meniscus is difficult to diagnose with imaging due to its absence of tears or anomalies. We aimed to clarify the accuracy of the preoperative diagnosis using magnetic resonance imaging (MRI). Methods: The preoperative MRI status of the posterosuperior popliteomeniscal fascicle (sPMF), anteroinferior popliteomeniscal fascicle (iPMF), and popliteal hiatus were examined retrospectively on sagittal images in the hypermobile lateral meniscus group (n = 22) and an age- and gender-matched control group (n = 44). These statuses were evaluated by a logistic regression analysis to assess their degree of diagnostic accuracy. Results: The area under the curve (AUC) of the sPMF, iPMF, popliteal hiatus, and all three criteria combined was 0.66, 0.74, 0.64, and 0.77, respectively (low, moderate, low, and moderate accuracy, respectively). The odds ratios of the most severe type 3 forms of the sPMF, iPMF, and popliteal hiatus for hypermobile lateral meniscus were significantly high (5.50, 12.20, and 5.00, respectively). Although the diagnostic accuracy was not high enough, the significantly higher odds ratio for type 3 may indicate a hypermobile lateral meniscus. Conclusion: a definitive diagnosis of hypermobile lateral meniscus is difficult with MRI findings alone; however, MRI evaluations of the iPMF, sPMF, and the widening of popliteal hiatus can be used as an adjunct to diagnosis.

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Section: Methodsmentioning

confidence: 99%

Preoperative Magnetic Resonance Imaging as a Diagnostic Aid for Hypermobile Lateral Meniscus

Toyooka

Shimazaki²,

Masuda

et al. 2021

Diagnostics

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“…The oldest study was published in 1988 [33] and the newest one in 2023 [7] and more than half of the studies were from the past 10 years. Regarding the study design, all of the articles were descriptive, of which 12 studies were case reports [3,8,11,12,17,29,34,35,[40][41][42][43] and eight were case series [7,19,22,24,31,33,49,53]. Therefore, all studies had a level of evidence of IV according to the Oxford Center of Evidence-Based Medicine criteria.…”

Section: Study Characteristics and Quality Assessmentmentioning

confidence: 99%

“…In four studies [7,24,31,33], some patients were involved in sports activity, and the study by Van Steyn et al only reported patients with no sports activity [43]. Moreover, 14 studies specified that their cases had hypermobility in the posterior horn of the LM [7,11,12,17,19,22,24,29,31,34,35,40,42,43], and the rest of the studies did not specify any information in this regard [3,8,33,41,49,53]. While most of the included studies reported a traumatic PMF tear as the aetiology behind the HLM, seven of these studies declared no history of trauma in their cases [3,7,17,19,22,31,35].…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…The most frequent symptoms reported by the included articles for the patients with HLM comprised locking sensation (19 studies), knee pain (15 studies), snapping (five studies), giving way (two studies) and clicking (one study) (Table 3). Ten studies reported a mean duration from the beginning of symptoms in the cases till undergoing surgery, which ranged from 5.7 to 60 months [3,7,12,19,24,29,35,40,41,49]. The study by Van Steyn et al reported cases for whom surgery was performed 10 years after the symptoms had appeared [43].…”

Section: Preoperative Evaluationsmentioning

confidence: 99%

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Hypermobile lateral meniscus: A systematic review of current treatment options

Vosoughi,

Mafhoumi,

Gouravani

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe reliable data on the incidence of hypermobile lateral meniscus (HLM) and its clinical manifestations, diagnostic methods and therapeutic approaches are limited. This systematic study aimed to review available treatment options for HLM and the outcomes of each approach.MethodsA systematic search was performed in four electronic databases (PubMed, EMBASE, Scopus, Web of Science) to identify studies in which arthroscopically confirmed cases of HLM were treated surgically or nonsurgically, and the required data comprising study characteristics, patient data, treatment approaches and outcome measures were extracted from eligible studies.ResultsTwenty studies with a total of 212 patients (138 males and 74 females) and 219 knees were included. The most frequently reported symptoms were locking sensations, knee pain, giving way and snapping. Treatments used by the studies were: radiofrequency energy in two studies; arthroscopic partial meniscectomy in one study; open surgery in two studies; and arthroscopic meniscal repair in 17 studies. Eleven studies used an all‐inside repair method and an inside‐out meniscal repair was reported in eight studies. Three studies reported the usage of posterior arthroscopy for therapeutic or diagnostic approaches. Evaluation of symptom resolution was the main outcome measurement for which almost all of the studies stated relief of symptoms after intervention.ConclusionDespite the lack of definite consensus about the most appropriate intervention for HLM, therapeutic preference was directed towards arthroscopic all‐inside and inside‐out repair techniques. Although the surgeon's decision remains the key factor in choosing the most suitable treatment option for each individual, posterior arthroscopic meniscal repair may be considered as a better option for HLM treatment according to the findings of this review.Level of EvidenceLevel IV.

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“…Additionally, hypermobility of the posterior horn of the lateral meniscus has been recently identified in case reports and limited case series. 11 , 12 , 13 , 14 Although the pathophysiology and optimal treatment have yet to be elucidated, this entity differs from a MCS because it exists in the absence of a discrete tear or traumatic capsular separation and is believed to be due to the disruption of the popliteomeniscal fascicles.…”

mentioning

confidence: 99%

Arthroscopic Diagnosis of Occult Posterolateral Meniscocapsular Separations: Another Hidden Lesion

Parisien

Shin

Boden

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose The purpose of this study was to describe the surgical findings and clinical outcomes in a series of patients with occult posterolateral meniscocapsular separations diagnosed arthroscopically after a negative magnetic resonance imaging (MRI) scan. Methods A retrospective analysis of prospectively collected data of consecutive patients who underwent surgical arthroscopy with repair of an occult posterolateral meniscocapsular separation by 2 fellowship-trained orthopaedic sports medicine surgeons at a single institution was performed. All lesions were identified arthroscopically in the posterolateral aspect of the lateral compartment as a distinct pathologic separation between the posterolateral capsule and adjacent meniscal tissue with increased excursion on probing. Clinical examination notes, MRI scans, and operative reports were reviewed. Patient-reported outcome measures were assessed via patient questionnaire. Results A total of 6 patients were included for analysis. MRI evaluation of the lateral meniscus was unrevealing in 4 patients, suggesting a possible tear of the body of the lateral meniscus in one patient and demonstrating a parameniscal cyst abutting the anterior root of the lateral meniscus in another patient. Arthroscopic examination revealed meniscocapsular separations of the posterolateral meniscus in all 6 knees, with 2 knees demonstrating concomitant bucket-handle meniscus tears. Patient-reported outcomes were determined for 67% of study patients. The average reported International Knee Documentation Committee score was 63.8, the average Knee Outcome Survey Activities of Daily Living Scale score was reported as 63, the 12-Item Short Form Survey (SF-12) Physical score averaged 46.8 with an average SF-12 Mental score of 59.9. Conclusions The diagnosis of occult posterolateral meniscocapsular separations (MCS) could be missed on advanced imaging, such as MRI, so arthroscopic diagnosis may be required. This study indicates that arthroscopic diagnosis and repair of occult posterolateral MCS results in good functional and clinical outcomes. Level of Evidence IV, therapeutic case series.

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MR Imaging of the Hypermobile Lateral Meniscus of the Knee: A Case Report

Cited by 8 publications

References 7 publications

Preoperative Magnetic Resonance Imaging as a Diagnostic Aid for Hypermobile Lateral Meniscus

Preoperative Magnetic Resonance Imaging as a Diagnostic Aid for Hypermobile Lateral Meniscus

Hypermobile lateral meniscus: A systematic review of current treatment options

Arthroscopic Diagnosis of Occult Posterolateral Meniscocapsular Separations: Another Hidden Lesion

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