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Case Reports
. 2014 Jul;24(3):291-6.
doi: 10.4103/0971-3026.137056.

MRI imaging of displaced meniscal tears: Report of a case highlighting new potential pitfalls of the MRI signs

Abhishek Prasad  1 , Rahat Brar  1 , Shaleen Rana  1
Affiliations
Case Reports

MRI imaging of displaced meniscal tears: Report of a case highlighting new potential pitfalls of the MRI signs

Abhishek Prasad et al. Indian J Radiol Imaging. 2014 Jul.

Abstract

Magnetic resonance imaging (MRI) has been found to be an excellent imaging tool for meniscal injuries. Various MRI signs have been described to detect displaced meniscal injuries, specifically the bucket-handle tears. Although these signs are quite helpful in diagnosing meniscal tears, various pitfalls have also been reported for these signs. Double anterior cruciate ligament (ACL) sign refers to presence of a linear hypointense soft tissue anterior to the ACL, which represented the flipped bucket-handle tear of the meniscus. Disproportional posterior horn and flipped meniscus signs represent asymmetrically thickened horns of the menisci due to overlying displaced meniscal fragments. We report a case wherein MRI of the knee showed tear and displacement of the medial patellofemoral ligament (MPFL) and vastus medialis complex, medial collateral ligament (MCL), and posterior cruciate ligament (PCL) mimicking these signs. To our knowledge, internally displaced MPFL and MCLs have not been described as mimics for displaced meniscal fragments.

Keywords: Bucket-handle tear; disproportional posterior horn; double anterior cruciate ligament sign; flipped meniscus sign; knee; magnetic resonance imaging.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
T2W sagittal image through the intercondylar fossa showing a thick “band-like” soft tissue (arrow) anteriosuperior to the ACL, mimicking the double ACL sign
Figure 2
Figure 2
T1W sagittal image at the same level as Figure 1 showing the thick band-like soft tissue (arrow) isointense to the anterior cruciate ligament
Figure 3
Figure 3
T2W sagittal image through the medial aspect of the knee joint showing a wedge-shaped soft tissue (arrow) superior to the body and posterior horn of medial meniscus, resembling the “posteriorly” flipped meniscus sign
Figure 4
Figure 4
T2W sagittal image through the intercondylar fossa of the knee joint showing a small triangular soft tissue (arrow) seen superior to the posterior horn of medial meniscus, resembling the disproportional posterior horn sign
Figure 5 (A–C)
Figure 5 (A–C)
Consecutive T2W axial images at the level of patellofemoral joint showing torn medial patellofemoral ligament which is displaced internally (arrow), causing a fallacious double ACL sign
Figure 6 (A–C)
Figure 6 (A–C)
Consecutive STIR coronal images showing complete tear of the femoral attachment of medial collateral ligament. The torn ligament is seen internally displaced and lying superior to the medial meniscus (arrows)
Figure 7 (A–C)
Figure 7 (A–C)
Consecutive STIR coronal images in the posterior aspect of the knee joint showing torn redundant PCL (arrow) lying over the posterior horn of medial meniscus
See this image and copyright information in PMC

References

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