Weekly Case

Title : Case 776

Age / Sex : 54 / M


Chief complaint : knee pain for 8 months (exacerbated during deep flexion)


What is your diagnosis?

Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer).

Courtesy : 이재혁(Yi Jaehyuck) 계명대동산병원(KEIMYUNG UNIVERSITY DONGSAN HOSPITAL)


Diagnosis:

Lateral meniscus posterior root tear (with meniscofemoral ligament tear)



Discussion


Findings

Marginal blurring & T2 hyperintensity of LMPR & MFL

Discussion


  • Lateral meniscus posterior root tear (LMPRT)


  - usually traumatic & associated with ACL injury (7–12% of patients with ACL injury); only 0.8% isolated injury


    * cf. medial meniscus posterior root injury: mainly degenerative


  - Meniscofemoral ligament (MFL): significant role (+) in load transmission of the lateral femorotibial compartment


  - if complete tear of LMPR (+),↑lateral compartment peak contact pressure by a mean of 43 % & ↓ maximum lateral compartment contact area by a mena of 47%



  • Arthroscopic classification of LMPRT (Forkel and Petersenet. 2012)


  - type 1: avulsion of the root with an intact meniscofemoral ligament (MFL)


  - type 2: radial tear of the root with an intact MFL


  - type 3: root avulsion or radial tear with rupture or absence of the MFL



  • MRI findings


  - ‘ghost meniscus sign’ on sagittal fluid-sensitive images


  - LM extrusion: relatively infrequent (more frequent in patients with MFL tear)



References


  1. Matthias J. Feucht et al. Knee Surg Sports Traumatol Arthrosc 2015;23:119–125

  2. Andrew R. Palisch et al. RadioGraphics 2016;36:1792–1806



Correct Answer
Total applicants 35 Correct answers 6
Name Institution
이혜란 전문의
전인환 전문의
강지희 전문의
최희석 나사렛국제병원, 전문의
김성진 365병원, 전문의
이민수 전문의
Semi-Correct Answer
Total applicants 35 Semi-Correct answers 6
이진영 전문의
장성원 전문의
장영실 전공의
최형인 분당서울대학교병원, 전문의
박소연 일산백병원, 전공의
김형민 전문의


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