Radial tear of medial meniscus and discoid lateral meniscus

Case contributed by Magdalena Chmiel-Nowak
Diagnosis certain

Presentation

Twisting knee injury four months ago.

Patient Data

Age: 60 years
Gender: Female

Joint effusion and reactive synovial proliferation in the suprapatellar recess.

A high-grade radial tear of the posterior horn of the medial meniscus, with almost 'ghost' appearance, extending to the posterior root. The meniscal body is extruded, pushing the medial collateral ligament. Accompanying extensive full-thickness chondral loss and subchondral changes in the medial joint compartment, in keeping with grade 4 Outerbridge chondral injury.

Lateral discoid meniscus with no posttraumatic lesions.

Case Discussion

Meniscal tears of or extending into the posterior root are often associated with meniscal extrusion, as the meniscus loses its attachment to the tibia and subluxates medially. This, in turn, impairs the meniscal ability to absorb the load and accelerates osteoarthritis changes - as seen in this case. Root tears can be repaired but they are often missed at arthroscopy, so it is important to always check the areas of the meniscal roots on MR.

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