3. When a meniscal tear is identified, accu-rate description and classification of the tear pattern can guide the referring clinician in patient education and surgical planning. Longitudinal tears 2. Normal menisci. A longitudinal tear usually begins in the posterior horn and is typically peripherally located. Variations Flap, complex, degenerative bucket-handle tear Other types of vertical tear include flap tears and radial tears. MFC medial femoral condyle Horizontal tears 3. Variations Flap tears, complex tears, degenerative tears Surg Annu 1977;9:267 Classifications by O'Connor Meniscal Tear 1. Radial tears 5. Isolated anterior horn longitudinal tears are rare. tear include discoid meniscus, meniscal flounce, a meniscal ossicle, and chondrocalcinosis. Longitudinal tears are often amenable to repair, whereas horizontal and radial tears may require partial meniscectomy (50,51). 1. There is a longitudinal tear in the periphery of the meniscus (red arrow). Longitudinal tear of the posterior horn. The outside one-third of the meniscus is called the 'red' zone, because it has a rich blood supply. For example, longitudinal tears are often amenable to repair, whereas MRI has sensitivity of 87–96% and specificity of 84–94% for medial meniscal tears and sensitivity of 70–92% with specificity of 91–98% for diagnosing tears of the lateral meniscus [1–5].Identification of meniscal tears has long been based on two criteria: intrameniscal signal intensity exiting the superior or inferior articular surface of the meniscus on short TE … Sagittal proton density (PD) images through normal medial ( a) and lateral ( b) menisci in cross section demonstrate the normal appearance of the anterior and posterior horns as black triangles. Longitudinal tears 2. Oblique tears 4. A man in his 20s. Oblique tears 4. Central tears are located on the inner side of the meniscus. Forty percent of the knees with a meniscal tear had a horizontal tear, 37% a complex tear, 12% an oblique tear, 15% a radial tear, 7% a longitudinal tear, and 1% a root tear. 12 Anterior horn tears are less common and located in the front of the meniscus. Posterior horn tears are much more common and located in the back of the meniscus. The central fragment of a meniscus with a peripheral longitudinal tear may displace centrally into the joint creating a bucket-handle tear. 3.1. A bucket-handle tear of the meniscus is a subtype of longitudinal tear, typically beginning in the posterior horn, extending longitudinally through the body and towards the anterior horn. In addition to describing the type of tear, most MRI and surgical reports will describe the location of the tear. Meniscus Tear MRI Correlation. Radial tears 5. A longitudinal tear is a vertical tear around the long axis of the meniscus. Fig. In another study, a peripheral longitudinal tear of the lateral meniscus was likely if the meniscofemoral ligament attachment to the lateral meniscus extended 14 mm or more lateral to the PCL . Horizontal tears 3. Meniscal tears can be treated with conservative therapy, surgical repair, or partial or complete meniscectomy. There is a full-thickness longitudinal tear extending from the posterior horn to the middle segment of the medial meniscus (MM) (arrows). (a) Coronal T2*WI and (b) arthroscopic image. Longitudinal tears tend to occur in younger patients, after significant trauma, and have a propensity to involve the periphery of the meniscus.
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