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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2014; 24(03): 291-296
DOI: 10.4103/0971-3026.137056
Musculoskeletal Radiology

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

Abhishek Prasad
Department of Radiology, Sector 62, Phase VIII, Fortis Hospital, Mohali, Punjab, India
,
Rahat Brar
Department of Radiology, Sector 62, Phase VIII, Fortis Hospital, Mohali, Punjab, India
,
Shaleen Rana
Department of Radiology, Sector 62, Phase VIII, Fortis Hospital, Mohali, Punjab, India
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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.

Keywords

Bucket‑handle tear - disproportional posterior horn - double anterior cruciate ligament sign - flipped meniscus sign - knee - magnetic resonance imaging


Publication History

Article published online:
02 August 2021

© 2014. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Singson RD, Feldman F, Staron R, Kiernan H. MR imaging of displaced bucket-handle tear of the medial meniscus. AJR Am J Roentgenol 1991;156:121-4.
  • 2 Weiss KL, Morehouse HT, Levy IM. Sagittal MR images of the knee: Low signal band parallel to the posterior cruciate ligament caused by a displaced bucket-handle tear. AJR Am J Roentgenol 1991;156:117-9.
  • 3 Wright DH, De Smet AA, Norris M. Bucket handle tear of the medial and lateral menisci of the knee: Value of MR imaging in detecting displaced fragments. AJR Am J Roentgenol 1995;165:621-5.
  • 4 Haramati N, Staron RB, Rubin S, Shreck EH, Feldman F, Kierman H. The flipped meniscus sign. Skeletal Radiol 1993;22:273-7.
  • 5 Helms CA, Laorr A, Cannon WD. The absent bow tie sign in bucket-handle tears of the menisci in the knee. AJR Am J Roentgenol 1998;170:57-61.
  • 6 Ruff C, Weingardt JP, Russ PD, Kilcoyne RF. MR imaging patterns of displaced meniscus injuries of the knee. AJR Am J Roentgenol 1998;170:63-7.
  • 7 Chen HC, Hsu CY, Shih TT, Huang KM, Li YW. MR imaging of displaced meniscal tears of the knee: Importance of a "disproportional posterior horn sign". Acta Radiol 2001;42:417-21.
  • 8 Aydingöz U1, Firat AK, Atay OA, Doral MN. MR imaging of meniscal bucket-handle tears: A review of signs and their relation to arthroscopic classification. Eur Radiol 2003;13:618-25.
  • 9 Takayama K, Matsushita T, Matsumoto T, Kubo S, Kurosaka M, Kuroda R. The double ACL sign: An unusual bucket-handle tear of medial Meniscus. Knee Surg Sports Traumatol Arthrosc 2011;19:1343-6.
  • 10 Guerrero P, Li X, Patel K, Brown M, Busconi B. Medial patellofemoral ligament injury patterns and associated pathology in lateral patella dislocation: An MRI study. Sports Med Arthrosc Rehabil Ther Technol 2009;1:17.
  • 11 Lecas LK, Helms CA, Kosarek FJ, Garret WE. Inferiorly displaced flap tears of the medial meniscus: MR appearance and clinical significance. AJR Am J Roentgenol 2000;174:161-4.
  • 12 Venkatanarasimha N, Kamath A, Mukherjee K, Kamath S. Potential pitfalls of a double PCL sign. Skeletal Radiol 2009;38:735-9.