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MRI imaging of displaced meniscal tears: Report of a case highlighting new potential pitfalls of the MRI signs.

Prasad A, Brar R, Rana S - Indian J Radiol Imaging (2014)

Bottom Line: Disproportional posterior horn and flipped meniscus signs represent asymmetrically thickened horns of the menisci due to overlying displaced meniscal fragments.We report a case wherein MRI of the knee showed tear and displacement of the medial patellofemoral ligament (MPFL) and vastus medialis complex, medial collateral ligament (MCL), and posterior cruciate ligament (PCL) mimicking these signs.To our knowledge, internally displaced MPFL and MCLs have not been described as mimics for displaced meniscal fragments.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Sector 62, Phase VIII, Fortis Hospital, Mohali, Punjab, India.

ABSTRACT
Magnetic resonance imaging (MRI) has been found to be an excellent imaging tool for meniscal injuries. Various MRI signs have been described to detect displaced meniscal injuries, specifically the bucket-handle tears. Although these signs are quite helpful in diagnosing meniscal tears, various pitfalls have also been reported for these signs. Double anterior cruciate ligament (ACL) sign refers to presence of a linear hypointense soft tissue anterior to the ACL, which represented the flipped bucket-handle tear of the meniscus. Disproportional posterior horn and flipped meniscus signs represent asymmetrically thickened horns of the menisci due to overlying displaced meniscal fragments. We report a case wherein MRI of the knee showed tear and displacement of the medial patellofemoral ligament (MPFL) and vastus medialis complex, medial collateral ligament (MCL), and posterior cruciate ligament (PCL) mimicking these signs. To our knowledge, internally displaced MPFL and MCLs have not been described as mimics for displaced meniscal fragments.

No MeSH data available.


Related in: MedlinePlus

T2W sagittal image through the intercondylar fossa showing a thick “band-like” soft tissue (arrow) anteriosuperior to the ACL, mimicking the double ACL sign
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Figure 1: T2W sagittal image through the intercondylar fossa showing a thick “band-like” soft tissue (arrow) anteriosuperior to the ACL, mimicking the double ACL sign

Mentions: Interesting observations were made on sagittal T1W and T2W sequences through the intercondylar fossa, which showed linear band-like soft tissue anterior to the ACL, giving a “double ACL sign” [Figures 1 and 2]. Additionally, wedge-shaped soft tissues were seen on sagittal T2W sequences overlying the posterior horns of medial meniscus, resembling “disproportional posterior horn sign” or a “flipped (posterior) meniscus sign” [Figures 3 and 4]. These findings raised the suspicion of displaced meniscal tears.


MRI imaging of displaced meniscal tears: Report of a case highlighting new potential pitfalls of the MRI signs.

Prasad A, Brar R, Rana S - Indian J Radiol Imaging (2014)

T2W sagittal image through the intercondylar fossa showing a thick “band-like” soft tissue (arrow) anteriosuperior to the ACL, mimicking the double ACL sign
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126146&req=5

Figure 1: T2W sagittal image through the intercondylar fossa showing a thick “band-like” soft tissue (arrow) anteriosuperior to the ACL, mimicking the double ACL sign
Mentions: Interesting observations were made on sagittal T1W and T2W sequences through the intercondylar fossa, which showed linear band-like soft tissue anterior to the ACL, giving a “double ACL sign” [Figures 1 and 2]. Additionally, wedge-shaped soft tissues were seen on sagittal T2W sequences overlying the posterior horns of medial meniscus, resembling “disproportional posterior horn sign” or a “flipped (posterior) meniscus sign” [Figures 3 and 4]. These findings raised the suspicion of displaced meniscal tears.

Bottom Line: Disproportional posterior horn and flipped meniscus signs represent asymmetrically thickened horns of the menisci due to overlying displaced meniscal fragments.We report a case wherein MRI of the knee showed tear and displacement of the medial patellofemoral ligament (MPFL) and vastus medialis complex, medial collateral ligament (MCL), and posterior cruciate ligament (PCL) mimicking these signs.To our knowledge, internally displaced MPFL and MCLs have not been described as mimics for displaced meniscal fragments.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Sector 62, Phase VIII, Fortis Hospital, Mohali, Punjab, India.

ABSTRACT
Magnetic resonance imaging (MRI) has been found to be an excellent imaging tool for meniscal injuries. Various MRI signs have been described to detect displaced meniscal injuries, specifically the bucket-handle tears. Although these signs are quite helpful in diagnosing meniscal tears, various pitfalls have also been reported for these signs. Double anterior cruciate ligament (ACL) sign refers to presence of a linear hypointense soft tissue anterior to the ACL, which represented the flipped bucket-handle tear of the meniscus. Disproportional posterior horn and flipped meniscus signs represent asymmetrically thickened horns of the menisci due to overlying displaced meniscal fragments. We report a case wherein MRI of the knee showed tear and displacement of the medial patellofemoral ligament (MPFL) and vastus medialis complex, medial collateral ligament (MCL), and posterior cruciate ligament (PCL) mimicking these signs. To our knowledge, internally displaced MPFL and MCLs have not been described as mimics for displaced meniscal fragments.

No MeSH data available.


Related in: MedlinePlus