Meniscal root tear

Changed by Joshua Yap, 11 Oct 2023
Disclosures - updated 16 Jul 2023: Nothing to disclose

Updates to Article Attributes

Body was changed:

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. They often tend to be radial tears extending into the meniscal root

Epidemiology

According to one source, they are thought to account for ~10% of all arthroscopic meniscectomies 5.

Associations
  • ACL tears are associated with posterior horn root tears of the lateral meniscus ref

Pathology

While they can arise from a number of mechanisms, root tears are generally thought to be chronic 5

Associations
  • ACL tears are associated with posterior horn root tears of the lateral meniscus ref
Classification

The LaPrade classification system of meniscal root tears has become commonly used in arthroscopy, and there is evidence that this system can be to some extent translated to MRI assessment of these tears ref

Radiographic features

MRI

Best assessed on T2 weighted sequences. When it involves the posterior root, medial root tears are easier to diagnose than lateral root tears.

On medial posterior root tears there is often 2:

  • shortening or absence of the root on sagittal images

  • vertical fluid cleft on coronal fluid-sensitive (T2) images

On posterior root radial tears of the lateral meniscus, the appearance may be similar to radial tears in other locations.

For root tears in general, sagittal imaging may demonstrate a meniscal ghost sign.

Other features include:

History and etymology

They were first described by M J Pagnani et al. in 1991 6.

  • -<p><strong>Meniscal root tears</strong> are a type of <a href="/articles/meniscal-tear">meniscal tear</a> in the knee where the tear extends to either the anterior or posterior meniscal root attachment to the central tibial plateau. They often tend to be radial tears extending into the <a href="/articles/meniscal-root">meniscal root</a>. </p><h4>Epidemiology</h4><p>According to one source, they are thought to account for ~10% of all arthroscopic meniscectomies <sup>5</sup>.</p><h4>Pathology</h4><p>While they can arise from a number of mechanisms, root tears are generally thought to be chronic <sup>5</sup>. </p><h5>Associations</h5><ul><li>
  • -<a href="/articles/anterior-cruciate-ligament-tear">ACL tears</a> are associated with posterior horn root tears of the lateral meniscus <sup>ref</sup>
  • -</li></ul><h5>Classification</h5><p>The <a href="/articles/laprade-classification-system-of-meniscal-root-tears">LaPrade classification system</a> of meniscal root tears has become commonly used in arthroscopy, and there is evidence that this system can be to some extent translated to MRI assessment of these tears <sup>ref</sup>. </p><h4>Radiographic features</h4><h5>MRI</h5><p>Best assessed on T2 weighted sequences. When it involves the posterior root, medial root tears are easier to diagnose than lateral root tears.</p><p>On medial posterior root tears there is often <sup>2</sup>:</p><ul>
  • -<li>shortening or absence of the root on sagittal images</li>
  • -<li>vertical fluid cleft on coronal fluid-sensitive (T2) images</li>
  • -</ul><p>On posterior root radial tears of the lateral meniscus, the appearance may be similar to radial tears in other locations.</p><p>For root tears in general, sagittal imaging may demonstrate a <a href="/articles/ghost-meniscus">meniscal ghost sign</a>.</p><p>Other features include:</p><ul>
  • -<li>
  • -<a href="/articles/truncation-sign">truncation sign</a> on coronal images<sup> 4</sup>
  • -</li>
  • -<li>features <a href="/articles/meniscal-extrusion">meniscal extrusion</a> on coronal plane <sup>4</sup>
  • -</li>
  • -</ul><h4>History and etymology</h4><p>They were first described by <strong>M J Pagnani</strong> et al. in 1991<sup> 6</sup>.</p>
  • +<p><strong>Meniscal root tears</strong> are a type of <a href="/articles/meniscal-tear">meniscal tear</a> in the knee where the tear extends to either the anterior or posterior meniscal root attachment to the central tibial plateau. They often tend to be radial tears extending into the <a href="/articles/meniscal-root">meniscal root</a>. </p><h4>Epidemiology</h4><p>According to one source, they are thought to account for ~10% of all arthroscopic meniscectomies <sup>5</sup>.</p><h5>Associations</h5><ul><li><p><a href="/articles/anterior-cruciate-ligament-tear">ACL tears</a> are associated with posterior horn root tears of the lateral meniscus <sup>ref</sup></p></li></ul><h4>Pathology</h4><p>While they can arise from a number of mechanisms, root tears are generally thought to be chronic <sup>5</sup>. </p><h5>Classification</h5><p>The <a href="/articles/laprade-classification-system-of-meniscal-root-tears">LaPrade classification system</a> of meniscal root tears has become commonly used in arthroscopy, and there is evidence that this system can be to some extent translated to MRI assessment of these tears <sup>ref</sup>. </p><h4>Radiographic features</h4><h5>MRI</h5><p>Best assessed on T2 weighted sequences. When it involves the posterior root, medial root tears are easier to diagnose than lateral root tears.</p><p>On medial posterior root tears there is often <sup>2</sup>:</p><ul>
  • +<li><p>shortening or absence of the root on sagittal images</p></li>
  • +<li><p>vertical fluid cleft on coronal fluid-sensitive (T2) images</p></li>
  • +</ul><p>On posterior root radial tears of the lateral meniscus, the appearance may be similar to radial tears in other locations.</p><p>For root tears in general, sagittal imaging may demonstrate a <a href="/articles/ghost-meniscus">meniscal ghost sign</a>.</p><p>Other features include:</p><ul>
  • +<li><p><a href="/articles/truncation-sign">truncation sign</a> on coronal images<sup> 4</sup></p></li>
  • +<li><p>features <a href="/articles/meniscal-extrusion">meniscal extrusion</a> on coronal plane <sup>4</sup></p></li>
  • +</ul><h4>History and etymology</h4><p>They were first described by M J Pagnani et al. in 1991<sup> 6</sup>.</p>
Images Changes:

Image 1 MRI (T2 fat sat) ( update )

Caption was changed:
Case 1: green arrow

Image 5 MRI (T2 fat sat) ( update )

Caption was changed:
Case 5: posterior root of medial meniscus

Image 6 MRI (Gradient Echo) ( update )

Caption was changed:
Case 6: posterior root tear of medial meniscus

Image 7 MRI (PD fat sat) ( update )

Caption was changed:
Case 7: posterior root of medial meniscus

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