Posterior Lateral Meniscus Horn Tear
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Next case, we have a 23-year-old pro baseball player
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with lateral knee pain.
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And again, I, I usually like to go medial to lateral.
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You see the MCL here,
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and as we're scrolling through the, uh, body
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and into the posterior horn of the medial meniscus, um,
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somebody had, uh, asked about this, the,
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the ramp lesion area.
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Uh, this is a, a meniscal capsular ligament,
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and you see a very nice meniscal tibial ligament.
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And, uh, in this particular anatomic variant,
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there's a nice meniscocapsular recess just
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because of distension of this portion
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of the joint in this particular patient.
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All of this is intact as we go.
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Um, you, uh, more laterally, you see the, uh,
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PCL is is good.
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The ACL is intact.
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And when we get to the posterior horn
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of the lateral meniscus, you see this vertical fluid cleft.
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Um, at the periphery of the lateral meniscus.
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It involves the inferior surface,
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and this is consistent with the tear.
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And now we see, um, intact, um,
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poster superior popal meniscal fassal,
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and this is the anterior inferior popal,
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meniscal fassal as well.
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But, um, we have a, a meniscal tear, uh,
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posterior horn, lateral meniscus.
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And on the axial images, you can see
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that this, um, if, if you wanted to measure a length, it's,
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um, probably about close
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to almost two centimeters in, in length.
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This went for arthroscopy as well.
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And the, uh, the surgeon is using a probe,
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an arthroscopic probe to probe the under surface.
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And this probe extends, um, into the, uh, tear.
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And they're, they're able to, to draw it inwards.
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And this corresponded very nicely. They used it.
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Um, they, they did an all inside repair.
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Um, they fired off a single suture anchor.
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Um, and that's, this is the final product on over here.
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One year later, uh, the patient has, uh, persistent symptoms
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and is coming back for, uh, imaging again.
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And this is case three B. This was an MR.
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Arthrogram at this point in time.
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And when we get
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to this posterior horn, uh, the lateral meniscus area,
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you see that, um, it, it's a very similar appearance to
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what, what it looked like preoperatively.
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Uh, there's this, uh, very similar tear configuration.
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Uh, this vertical cleft, um, uh, this violates
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that inferior surface at the peripheral third
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of the lateral meniscus, um, pushed your horn.
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So, um, we could say that there's a tear.
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Uh, the deri, the description could be that it's a, uh,
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recurrent or persistent.
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We don't really know whether it had healed.
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Um, uh, in any event, you can, you can confidently say
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that there is a tear on these postoperative, uh, cases.
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Um, if fluid or gadolinium in this case extends, uh, uh,
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into that tear.
Donald Resnick, MD
Professor Emeritus, Department of Radiology
University of California, San Diego
Mini N. Pathria, MD, FRCP(C)
Division Chief, Musculoskeletal Imaging
University of California San Diego
Eric Y. Chang, MD
Adjunct Professor, Radiology
University of California, San Diego
Brady K. Huang, MD
Clinical Professor of Radiology
UC San Diego Medical Center
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