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Radiologie up2date 2023; 23(02): 157-173
DOI: 10.1055/a-2067-1190
Muskuloskelettale Erkrankungen

Dislozierte Meniskusläsionen

Displaced Meniscal Tears
Rainer Wunn
,
Josef Kramer
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Zusammenfassung

Die MRT ist als nicht invasive Methode mit hohem Weichteilkontrast zum Goldstandard in der Diagnostik von Meniskusläsionen geworden. Verlagerte Meniskusanteile sind oft eine Blickdiagnose. Manchmal sind jedoch nur kleine Anteile betroffen, die der Wahrnehmung entgehen können. Dieser Beitrag erklärt die Grundlagen von Meniskusrissen, wie Meniskusdislokationen entstehen und die Zeichen, an denen Verlagerungen zu erkennen sind.

Abstract

As a non-invasive method with high soft-tissue contrast, MRI is gold standard in the diagnosis of meniscal lesions. Dislocated meniscus tears are most of the time simple to diagnose. Sometimes, however, only small portions are affected which can be overlooked. The exact description of the tear is important for the further therapeutic approach and thus basis of the radiological report. This article explains the basics of meniscus tears, how meniscus dislocations occur and shows signs how those shifts can be recognized.

Kernaussagen

  • Eine der wichtigsten Aufgaben der Menisken ist eine adäquate Druckverteilung. Bei einem Riss kann diese Aufgabe, abhängig vom Rissverlauf, nicht mehr erfüllt werden und es kommt zu einer vorzeitigen Arthrose.

  • Der Verlauf eines Risses gibt Aufschluss über potenzielle Verlagerungsmöglichkeiten. Je länger der Riss ist, umso wahrscheinlicher ist eine Verlagerung.

  • Verlagerten Meniskusanteilen kommt eine besondere Bedeutung zu, weil diese oft eine operative Behandlung erfordern.

  • Die Kenntnis der Anatomie, der Varianten und der radiologischen Zeichen ebnet den Weg zur richtigen Diagnose und hilft den behandelnden Ärztinnen und Ärzten dabei, eine adäquate Therapie einzuleiten und unnötige Operationen zu vermeiden.

Schlüsselwörter

Meniskus - Meniskusläsion - Meniskusbildgebung - MRT

Key words

meniscus - meniscal tears - meniscal imaging - MRI


Publication History

Article published online:
08 June 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Fox MG. MR imaging of the meniscus: review, current trends, and clinical implications. Radiol Clin North Am 2007; 45: 1033-1053
    CrossrefPubMedSearch in Google Scholar
  • 2 Fithian DC, Kelly MA, Mow VC. Material properties and structure-function relationships in the menisci. Clin Orthop Relat Res 1990; 252: 19-31
    CrossrefPubMedSearch in Google Scholar
  • 3 Fox AJ, Wanivenhaus F, Burge AJ. et al. The human meniscus: a review of anatomy, function, injury, and advances in treatment. Clin Anat 2015; 28: 269-287
    CrossrefPubMedSearch in Google Scholar
  • 4 Renström P, Johnson RJ. Anatomy and biomechanics of the menisci. Clin Sports Med 1990; 9: 523-538
    CrossrefPubMedSearch in Google Scholar
  • 5 Clark CR, Ogden JA. Development of the menisci of the human knee joint. Morphological changes and their potential role in childhood meniscal injury. J Bone Joint Surg Am 1983; 65: 538-547
    CrossrefPubMedSearch in Google Scholar
  • 6 Fukubayashi T, Torzilli PA, Sherman MF. et al. An in vitro biomechanical evaluation of anterior-posterior motion of the knee. Tibial displacement, rotation, and torque. J Bone Joint Surg Am 1982; 64: 258-264
    CrossrefPubMedSearch in Google Scholar
  • 7 Shoemaker SC, Markolf KL. The role of the meniscus in the anterior-posterior stability of the loaded anterior cruciate-deficient knee. Effects of partial versus total excision. J Bone Joint Surg Am 1986; 68: 71-79
    CrossrefPubMedSearch in Google Scholar
  • 8 Vedi V, Williams A, Tennant SJ. et al. Meniscal movement. An in-vivo study using dynamic MRI. J Bone Joint Surg Br 1999; 81: 37-41
    CrossrefPubMedSearch in Google Scholar
  • 9 Simonian PT, Sussmann PS, van Trommel M. et al. Popliteomeniscal fasciculi and lateral meniscal stability. Am J Sports Med 1997; 25: 849-853
    CrossrefPubMedSearch in Google Scholar
  • 10 Simonian PT. et al. Popliteomeniscal fasciculi and the unstable lateral meniscus: clinical correlation and magnetic resonance diagnosis. Arthroscopy 1997; 13: 590-596
    CrossrefPubMedSearch in Google Scholar
  • 11 LaPrade RF. Arthroscopic evaluation of the lateral compartment of knees with grade 3 posterolateral knee complex injuries. Am J Sports Med 1997; 25: 596-602
    CrossrefPubMedSearch in Google Scholar
  • 12 Amis AA, Bull AM, Gupte CM. et al. Biomechanics of the PCL and related structures: posterolateral, posteromedial and meniscofemoral ligaments. Knee Surg Sports Traumatol Arthrosc 2003; 11: 271-281
    Search in Google Scholar
  • 13 Wan AC, Felle P. The menisco-femoral ligaments. Clin Anat 1995; 8: 323-326
    Search in Google Scholar
  • 14 Gupte CM, Smith A, McDermott ID. et al. Meniscofemoral ligaments revisited. Anatomical study, age correlation and clinical implications. J Bone Joint Surg Br 2002; 84: 846-851
    CrossrefPubMedSearch in Google Scholar
  • 15 Arnoczky SP, Warren RF. Microvasculature of the human meniscus. Am J Sports Med 1982; 10: 90-95
    Search in Google Scholar
  • 16 Mordecai SC, Al-Hadithy N, Ware HE. et al. Treatment of meniscal tears: An evidence based approach. World J Orthop 2014; 5: 233-241
    CrossrefPubMedSearch in Google Scholar
  • 17 Roos H, Laurén M, Adalberth T. et al. Knee osteoarthritis after meniscectomy: prevalence of radiographic changes after twenty-one years, compared with matched controls. Arthritis Rheum 1998; 41: 687-693
    CrossrefPubMedSearch in Google Scholar
  • 18 Ahmed AM, Burke DL. In-vitro measurement of static pressure distribution in synovial joints-Part I: Tibial surface of the knee. J Biomech Eng 1983; 105: 216-225
    CrossrefPubMedSearch in Google Scholar
  • 19 Baratz ME, Fu FH, Mengato R. Meniscal tears: the effect of meniscectomy and of repair on intraarticular contact areas and stress in the human knee. A preliminary report. Am J Sports Med 1986; 14: 270-275
    CrossrefPubMedSearch in Google Scholar
  • 20 Rubin DA, Paletta GA. Current concepts and controversies in meniscal imaging. Magn Reson Imaging Clin N Am 2000; 8: 243-270
    CrossrefPubMedSearch in Google Scholar
  • 21 Stoller DW, Martin C, Crues JV. et al. Meniscal tears: pathologic correlation with MR imaging. Radiology 1987; 163: 731-735
    CrossrefPubMedSearch in Google Scholar
  • 22 De Smet AA, Tuite MJ. Use of the “two-slice-touch” rule for the MRI diagnosis of meniscal tears. AJR Am J Roentgenol 2006; 187: 911-914
    CrossrefPubMedSearch in Google Scholar
  • 23 Costa CR, Morrison WB, Carrino JA. Medial meniscus extrusion on knee MRI: is extent associated with severity of degeneration or type of tear?. AJR Am J Roentgenol 2004; 183: 17-23
    CrossrefPubMedSearch in Google Scholar
  • 24 Liu Y, Du G, Li X. Threshold for lateral meniscal body extrusion on MRI in middle-aged and elderly patients with symptomatic knee osteoarthritis. Diagn Interv Imaging 2020; 101: 677-683
    CrossrefPubMedSearch in Google Scholar
  • 25 Crema MD, Roemer FW, Felson DT. et al. Factors associated with meniscal extrusion in knees with or at risk for osteoarthritis: the Multicenter Osteoarthritis study. Radiology 2012; 264: 494-503
    CrossrefPubMedSearch in Google Scholar
  • 26 Ruff C, Weingardt JP, Russ PD. et al. MR imaging patterns of displaced meniscus injuries of the knee. AJR Am J Roentgenol 1998; 170: 63-67
    CrossrefPubMedSearch in Google Scholar
  • 27 Ververidis AN, Verettas DA, Kazakos KJ. et al. Meniscal bucket handle tears: a retrospective study of arthroscopy and the relation to MRI. Knee Surg Sports Traumatol Arthrosc 2006; 14: 343-349
    CrossrefPubMedSearch in Google Scholar
  • 28 Bollen SR. Posteromedial meniscocapsular injury associated with rupture of the anterior cruciate ligament: a previously unrecognised association. J Bone Joint Surg Br 2010; 92: 222-223
    CrossrefPubMedSearch in Google Scholar
  • 29 Liu X, Feng H, Zhang H. et al. Arthroscopic prevalence of ramp lesion in 868 patients with anterior cruciate ligament injury. Am J Sports Med 2011; 39: 832-837
    CrossrefPubMedSearch in Google Scholar
  • 30 Keyhani S, Esmailiejah AA, Mirhoseini MS. et al. The Prevalence, Zone, and Type of the Meniscus Tear in Patients with Anterior Cruciate Ligament (ACL) Injury; Does Delayed ACL Reconstruction Affects the Meniscal Injury?. Arch Bone Jt Surg 2020; 8: 432-438
    CrossrefPubMedSearch in Google Scholar
  • 31 Haramati N, Staron RB, Rubin S. et al. The flipped meniscus sign. Skeletal Radiol 1993; 22: 273-277
    CrossrefPubMedSearch in Google Scholar