MRI of meniscal bucket-handle tears |
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Authors: | T H Magee Gary W Hinson |
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Institution: | (1) Department of Radiology, Menorah Medical Center, 5721 West 119th Street, Overland Park, KS 66209, USA, US |
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Abstract: | Objective. A meniscal bucket-handle tear is a tear with an attached fragment displaced from the meniscus of the knee joint. Low sensitivity
of MRI for detection of bucket-handle tears (64% as compared with arthroscopy) has been reported previously. We report increased
sensitivity for detecting bucket-handle tears with the use of coronal short tau inversion recovery (STIR) images.
Design and patients. Three hundred and twenty-seven patients who had MRI of the knee between October 1994 and December 1996 and subsequently underwent
arthroscopy were included in the study. We prospectively and retrospectively reviewed the MR examinations of the 30 patients with arthroscopically proven bucket-handle tears. Each of
two observers examined each scan for the three traditional findings of bucket-handle tears: a double posterior cruciate ligament
sign, a flipped meniscus sign and/or a fragment in the intercondylar notch. We also assessed STIR images in the coronal plane
through the menisci looking for an area of increased signal within either meniscus with a displaced meniscal fragment.
Results. By using four criteria for diagnosis of meniscal bucket-handle tears, our overall sensitivity compared with arthroscopy was
93% (28 of 30 meniscal bucket-handle tears seen at arthroscopy were detected by MRI). The meniscal fragment was well visualized
in all 28 cases on coronal STIR images. The double posterior cruciate ligament sign was seen in 8 of 30 cases, the flipped
meniscus was seen in 10 of 30 cases and a fragment in the intercondylar notch was seen in 18 of 30 cases.
Conclusion. By using four criteria for diagnosis of bucket-handle tears, overall diagnostic sensitivity of MRI compared with arthroscopy
increased from the previously reported 64% to 93%. Coronal STIR images are useful for detecting small meniscal bucket-handle
tears. |
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Keywords: | MRI Knee Meniscal tear Bucket-handle tear Injury |
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