Yujin Yeo1, Joong Mo Ahn2, Hyorin Kim1, Yusuhn Kang1, Eugene Lee1, Joon Woo Lee1, Heung Sik Kang1. 1. Department of Radiology, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam, 13620, South Korea. 2. Department of Radiology, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam, 13620, South Korea. joongmoahn@gmail.com.
Abstract
OBJECTIVE: To identify the findings on magnetic resonance imaging most strongly associated with meniscal ramp lesions in patients with an anterior cruciate ligament tear. SUBJECTS AND METHODS: Seventy-eight consecutive patients (mean age, 33.7 years; 64 male, 14 female) with an arthroscopically proven anterior cruciate ligament tear were included in this retrospective study. The presence of the following six features on magnetic resonance images were recorded: complete fluid filling between the posterior horn of the medial meniscus and the capsule margin; edema affecting the posterior capsule; irregularity of the medial meniscus at the posterior margin; fluid at the periphery of the medial meniscus; the corner notch sign; and a vertical tear at the medial meniscus. Findings at arthroscopy served as the reference standard. Diagnostic accuracy, sensitivity, and interobserver agreement were calculated. RESULTS: Seven ramp lesions were noted on arthroscopy (9%). Findings of irregularity at the posterior margin (p = 0.001) and complete fluid filling between the posterior horn of the medial meniscus and the capsule margin (p = 0.004) on magnetic resonance imaging were significantly associated with the presence of a ramp lesion. With the irregularity at the posterior margin, sensitivity was 86% and specificity was 79%. Complete fluid filling sign showed sensitivity of 57% and specificity of 92%. Concordance of the two readers for the six magnetic resonance imaging features was fair to very good (k = 0.38-0.91). CONCLUSIONS: Irregularity at posterior margin and complete fluid filling were most sensitive findings for detecting of a ramp lesion on magnetic resonance imaging.
OBJECTIVE: To identify the findings on magnetic resonance imaging most strongly associated with meniscal ramp lesions in patients with an anterior cruciate ligament tear. SUBJECTS AND METHODS: Seventy-eight consecutive patients (mean age, 33.7 years; 64 male, 14 female) with an arthroscopically proven anterior cruciate ligament tear were included in this retrospective study. The presence of the following six features on magnetic resonance images were recorded: complete fluid filling between the posterior horn of the medial meniscus and the capsule margin; edema affecting the posterior capsule; irregularity of the medial meniscus at the posterior margin; fluid at the periphery of the medial meniscus; the corner notch sign; and a vertical tear at the medial meniscus. Findings at arthroscopy served as the reference standard. Diagnostic accuracy, sensitivity, and interobserver agreement were calculated. RESULTS: Seven ramp lesions were noted on arthroscopy (9%). Findings of irregularity at the posterior margin (p = 0.001) and complete fluid filling between the posterior horn of the medial meniscus and the capsule margin (p = 0.004) on magnetic resonance imaging were significantly associated with the presence of a ramp lesion. With the irregularity at the posterior margin, sensitivity was 86% and specificity was 79%. Complete fluid filling sign showed sensitivity of 57% and specificity of 92%. Concordance of the two readers for the six magnetic resonance imaging features was fair to very good (k = 0.38-0.91). CONCLUSIONS: Irregularity at posterior margin and complete fluid filling were most sensitive findings for detecting of a ramp lesion on magnetic resonance imaging.
Entities:
Keywords:
Magnetic resonance imaging; Meniscocapsular injury; Meniscocapsular separation; Ramp lesion
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