December 12, 2008

Meniscal Bucket-Handle Tear

Fig: Coronal T2 image (with fat suppression) shows a displaced fragment (arrow) of medial meniscus into the intercondylar notch of the knee. Note intact ACL (arrowheads).

What is 'Bucket-Handle' Tear?
  • Longitudinal, peripheral tear of the meniscus with displacement of fragment toward the intercondylar notch of the knee
  • Leads to locked knee and surgery (debridement or repair) is necessary
  • If occurs at the outer 1/3 (white/white zone), only debridement; if middle and peripheral third (white/red, red/red zones) require repair
How to Diagnose?
  • Using MRI with coronal and sagittal planes
  • Look for extra-structure in the intercondylar notch on coronal image!
  • Double PCL (posterior cruciate ligament) on sagittal image
  • Donor meniscus (usually medial) look smaller than usual (key to differentiate bucket-handle tear from normal oblique intermeniscal ligament)
Reference:
Stoller DW, et al. Diagnostic imaging: orthopedics. 2004

2 comments:

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