Robert laprade details the specifics on how to read knee mri of medial meniscus tear. Anterior cruciate ligament, arthroscopy, meniscus tear, magnetic resonance imaging. They may also prescribe physical therapy and antiinflammatory medication to help with the pain and swelling. Find out when it helps, what to expect, and how long youll need to do it for. Use zocdoc to book with doctors for an mri for a meniscus tear. The meniscus is a cshaped pad of specialized cartilage that functions as a shockabsorber within the knee. Pdf mri characteristics of torn and untorn postoperative menisci. An asymptomatic meniscal tear finding on mri scan is common. There are three basic mr characteristicscriteria of meniscal tears 5.
The knee practical office orthopedics accessmedicine. A magnetic resonance imaging mri scan is often used to diagnose meniscal injuries. Meniscal diseases are commonly studied by means of mri which allows,, evaluation of meniscal injuries with high precision, showing 93% sensitivity and 88% specificity. It is well established that meniscal damage predisposes the adjacent articular cartilage to increased axial and sheer stress, resulting in early degenerative osteoarthritis. Lateral meniscal tears are more common in association with an acute acl tear 6. Reliability of clinical diagnosis in meniscal tears. Physical therapy pt and exercises for a meniscus tear rehab. And ordering an mri only shows you that a meniscus tear exists, but it doesnt tell the physician that the meniscus tear is painful. For example, longitudinal tears are often amenable to repair, whereas. Resection of torn portion of meniscus versus meniscal repair depends on physiologic patient age, quality of the tissue, tear pattern, tear location, and concomitant surgical pathology. Meniscus tears are either vertical, which are generally associated with traumatic injury, horizontal, which are associated with degenerative injury, or combinations.
The pain is typically worse with squatting or twisting the leg. Mri gives a good picture of the size of a meniscus tear and where it is. Mri of two different patients having horizontal meniscal tear. Stress between the bones is absorbed by the meniscus when you are active, such as when walking, jumping, climbing or running. Reliability of two clinical meniscal tests and magnetic resonance imaging. The exact role that the meniscus cartilages play in the function of the knee is poorly understood, but they do not act as a cushion between the femur and tibia, as many of us were taught see sidebar. Any information contained in this pdf file is automatically generated from digital material.
How well the knee will heal and whether surgery will be needed depends in large part on the type of tear see figure in appendix and how bad the tear is. Different tears commonly arise from different origins. In knee injuries, the phrase acl tear is probably the most dreaded words that you could ever hear, while having a torn meniscus does not seem to be as. Physical therapy pt can be useful for a torn meniscus whether or not you have surgery. Studies have suggested that surgeries to repair a torn meniscus dont actually lead to a fuller or quicker recovery than nonsurgical treatments. Due to the avascular and hypocellular nature of meniscal tissue, it possesses a capacity for healing once damaged 3,4. Meniscus tears are one of the most common injuries during activities that involve putting pressure on the knee or rotating the knee. A tear of the meniscus is a rather common injury, particularly in people who play sports. Though the guarded prognosis of meniscectomy was noticed as early.
The mri also shows degeneration of the lateral meniscus posterior horn. According to one source, they are thought to account for 10% of all arthroscopic meniscectomies 5. Longitudinal tear involving outer rd of medial meniscus red arrow. Injury a 20 year old male track athlete 5k and 10k distance events 3 years prior, consistent discomfort and pain along l medial joint line 4 weeks prior, escalated to extreme pain spoke with atc and consulted physicians preoperative exam and mri revealed a medial meniscus tear did not respond well to conservative. What are the treatment options for a degenerative meniscus.
It ranges from 5 % in young ages and up to 67 % in older ages. Meniscal root tears are a type of meniscal tear in the knee where the tear extends to either the anterior or posterior meniscal root attachment to the central tibial plateau. Meniscal tear arthroscopic view of tear regenerated meniscus 6. Others include a bucket handle tear where a relatively big piece of meniscus tears and jams the knee, causing it to become stuck. With a sensitivity of 95% and a specificity of 81% for medial meniscal tears and sensitivity of 85% and a specificity of 93% for lateral meniscal tears 2,5, mri is the modality of choice when a meniscal tear is suspected, with sagittal images being the most sensitive 5. There are 2 menisci in the knee joint one on the inside of the knee medial meniscus and one on the outside of the knee lateral meniscus.
When people talk about torn cartilage in the knee, they are usually referring to a torn meniscus. Recent advancements in surgical technique also include synthetic, autogenous, and allograft reconstructions. Department of radiology, hospital for special surgery, 535 east 70th street. Magnetic resonance imaging mri is the most accurate imaging technique in the diagnosis of meniscal lesions and represents a standard tool in. The big thing to differentiate meniscus tears from arthritis is that arthritis pain is typically in the front of. This article presents a program for rehabilitation after meniscal injuries, meniscectomy, and meniscal repair based on current knowledge of knee. Magnetic resonance imaging of knee joint international. Most of you who have a root tear do not recall an injury to your knee. The lateral meniscus can tear in a number of different ways including a complex tear a tear in more than one direction. Pdf magnetic resonance imaging is modality of choice for the noninvasive evaluation of meniscal tears. Work with your doctor to plan a rehabilitation rehab program that helps you regain as much. The meniscus is a cshaped piece of cartilage sited in the knee.
Smashwords medial meniscus tears, a simple guide to the. Meniscus tears can occur following a local trauma or spontaneously due to aging and degenerative processes. The reason that the true source of pain matters is that arthroscopy of the knee and trimming out the torn part of the meniscus only relieve pain from the meniscus tear. All patients attending our clinic with knee pain from january 2003 to december 2004 underwent systematic and thorough clinical assessment. Root tears of the medial meniscus are being recognized on an mri with increasing frequency. The physician treating an athlete with a known or suspected meniscal tear needs to understand the structure and function of the meniscus and the factors involved in treating an athlete with nonoperative versus operative treatment.
Magnetic resonance imaging mri is a test that provides pictures of organs, bones, and joints. A meniscus is rubbery, but it can tear when rotating or twisting the knee with your foot in contact with the ground. When a meniscal tear is identified, accurate description and classification of the tear pattern can guide the referring clinician in patient education and surgical planning. The clinical diagnosis of meniscal tear is not easy. When people tear it, they usually have swelling or pain in the knee. Additional mri characteristics associated with torn postoperative meniscus at surgery were. Rather, a combination of antiinflammatory medications or corticosteroid shots, knee brace use, and physical therapy will provide sufficient healing. Can you read your own knee mri for a meniscus tear. One hundred and fifty patients were clinically diagnosed to have meniscal tears. The cause of the tear matters, because that helps us determine what treatments to offer you.
Robert laprade details the specifics on how to read an mri of a medial meniscus tear. For a diagnosis of meniscal tear to be confirmed through mri, some criteria must be fulfilled, among which the extension of the hyperintense intrameniscal signal on short echotime sequences to one of the. Dont assume a meniscus tear seen on mri is the cause of knee pain ironically, pain is typically what drives a patient to get meniscus surgery in the irst place, yet chronic pain is the biggest complaint patients have following surgery. Hirschmann 3niccolorotigliano 3matthieuollivier 4 helderpereira 5reneverdonk 6nikicadarabos 7panagiotisntagiopoulos 8daviddejour 9romainseil 10,11 rolandbecker 12. Mrimaging of meniscal substitution journal of the belgian society. Sports injury medicine department 9250 sw hall blvd. Pdf meniscal injuries are recognized as a cause of significant.
Mr imagingbased diagnosis and classification of meniscal. Meniscal tears can be assessed arthroscopically for stability and vascularity. The meniscus is an essential member of the knee joint and without its proper functioning, pathologic force distribution and instability occur in the knee, negatively affecting overall joint biomechanics 1,2. They protect the joint and the knee stability torn medial meniscus can affect. They often tend to be radial tears extending into the meniscal root. An mri is 70 to 90 percent accurate in identifying whether the meniscus has been torn and how badly. Evaluation of medial meniscus tears and meniscal stability. The mri shows a medial meniscus tear of the right knee. The medial meniscus is semicircular in shape and the lateral meniscus is almost a. The meniscus is a piece of cartilage that acts like a cushion between your thigh and shin bones.
Meniscus tears can be acute, or due to an injury or a meniscus tear can be degenerative, where your cartilage is simply wearing out from a lifetime of activity. The last bone we need to add if we are building a knee is the patella. Both clinically positive meniscal tear and mri positive tear were present in 37. Pdf isakos classification of meniscal tears illustration on 2d. These signs are mri findings that can accompany meniscal tears. There is a medial meniscus and lateral meniscus in each knee. The value of standard radiography is extremely limited for the assessment of meniscal injuries but may be indicated to obtain a. How to recover from a meniscus tear without surgery. How i diagnose meniscal tears on knee mri arthur a. This retrospective study was conducted to analyse the reliability of clinical diagnosis in meniscal tear injuries.
The meniscus is the cartilage between the bones of the knee and its very common to tear those. It makes these images by using a magnetic field and pulses of radio wave energy. Chris centeno goes over what to look for on your mri and the different types of. The reliability of arthrography of the knee for the diagnosis of meniscal lesions is well established tears, buckethandle tears, and meniscocapsular separation with reliability between 83 and 94% 6, 7. All anatomical descriptions were clearly illustrated by mri, arthroscopy, andor drawings. The prevalence of asymptomatic tears, which typically are horizontal tears, increases with age 1,2. Meniscus tears will not show up on xrays so your physician may also order a mri of the knee.
Athletes, particularly those who play contact sports, are at risk for meniscus tears. How to read knee mri of medial meniscus tear video. Arthroscopic knee surgery is the gold standard in the diagnosis. Ppv, and npv for anterior cruciate ligament acl tear were 100%, 92%, 92%, and 100%. In general, optimal evaluation is achieved when the imaging planes are oriented. There are different types of meniscus tears and a horizontal cleavage tear occurs within the fibers of the meniscus and splits the meniscus in the top and bottom pieces. The older the patient is and the more osteoarthritic findings, the higher the prevalence. Accurate and timely diagnosis of a meniscal tear is critical for reducing morbidity and planning treatment.
Arthrography was the reference technique in the 1970s and 1980s and was given up after 2000 to be replaced by mri, which has the advantage of. How to read an mri of a medial meniscus tear minnesota. This book describes medial meniscus tears, diagnosis and treatment and related diseases meniscus tears are the medical injuries in the shockabsorbing cartilage of the knee. Meniscus reconstruction collagen meniscus implant cmi 50. Rehabilitation exercises a meniscus tear is a common knee joint injury.
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