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<v ->The lateral plica and lateral plica syndrome is debated.

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It's rarely reported in the literature.

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It's rarely seen at the time of arthroscopy.

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The people who believe there is a syndrome

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associated with folds in the lateral aspect of the knee,

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say you can have pain, again a snapping sensation,

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and they can feel the plica in any location

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when it's markedly thick.

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I'm taking these images from the literature,

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I don't have any good cases of my own,

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but here's one from RadioGraphics

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showing you a thickened lateral plica.

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Here's another one taken from a Radsource Web Clinic

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showing you what was reported to be

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a thickened lateral plica.

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There's a short medio plica as well, in this case.

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But it brings us to another entity

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that has received some attention in the recent literature.

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So I wanted to say a word or two about this entity.

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This condition has a very, very fancy name, it's known as

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an accessory iliotibial band - meniscal ligament.

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And what it is said to be is a band of tissue

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that extends from a portion of the iliotibial tract

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to attach to the anterior horn and body

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of the lateral meniscus.

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And therefore that lateral meniscus

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does not move in a normal fashion.

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Now, if you look,

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and you have a lot of experience with knee MR,

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you're gonna often see a shadow like this

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but in most cases you won't see fluid on both sides.

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In the article that came out,

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and this came out from Switzerland, in the Zurich area,

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they had beautiful arthroscopy pictures

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showing you this ligament

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associated with problems of a lateral meniscus.

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I'm not sure how specific this is.

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Here's pictures, first of all, from their article

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showing you that particular band or ligament

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attaching to a torn anterior horn and body

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of the lateral meniscus.

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Shortly thereafter, we came across one of our own cases

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that seemed to show a similar phenomenon.

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What appeared to be

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an accessory iliotibial band - meniscal ligament,

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attaching to an abnormal lateral meniscus.

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Some people who believe in this

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and think this is simply a plica,

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not a true ligament, I'm not sure.

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It has been reported in 13% of knee MRIs.

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So to be aware of it

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but I'm not sure it's a proven entity at this point.