MR imaging of meniscal bucket-handle tears: a review of signs and their relation to arthroscopic classification |
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Authors: | Aydingöz Ustün Firat Ahmet K Atay O Ahmet Doral M Nedim |
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Institution: | (1) Department of Radiology, Hacettepe University Medical Center, 06100 Ankara, Turkey,;(2) Department of Orthopaedics and Traumatology, Hacettepe University Medical Center, 06100 Ankara, Turkey, |
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Abstract: | Our objective was to review the MR imaging signs of meniscal bucket-handle tears and assess the relevance of these signs
to the arthroscopic classification of displaced meniscal tears. Forty-five menisci in 42 patients who had a diagnosis of bucket-handle
tear either on MR imaging or on subsequent arthroscopy (in which Dandy's classification of meniscal tears was used) were retrospectively
analyzed for MR imaging findings of double posterior cruciate ligament (PCL), fragment within the intercondylar notch, absent
bow tie, flipped meniscus, double-anterior horn, and disproportional posterior horn signs. Arthroscopy, which was considered
as the gold standard, revealed 41 bucket-handle tears (either diagnosed or not diagnosed by MR imaging) in 38 patients (33
males, 5 females). There was a stastistically significant male preponderance for the occurrence of meniscal bucket-handle
tears. Overall, sensitivity and positive predictive value of MR imaging for the detection of meniscal bucket-handle tears
were calculated as 90%. Common MR imaging signs of meniscal bucket-handle tears in arthroscopically proven cases of such tears
were the fragment in the notch and absent bow tie signs (98% frequency for each). Double-PCL, flipped meniscus, double-anterior
horn, and disproportional posterior horn signs, however, were less common (32, 29, 29, and 27%, respectively). An arthroscopically
proven bucket-handle tear was found in all patients who displayed at least three of the six MR imaging signs of meniscal bucket-handle
tears. The presence of three or more MR imaging signs of meniscal bucket-handle tears is highly suggestive of this condition.
Electronic Publication |
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Keywords: | Knee Meniscus tears MR imaging Arthroscopy |
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