Clinical considerations of anatomy and magnetic resonance imaging in pediatric meniscus tear, with imaging-based treatment options

Abstract

Background: The incidence of meniscal tears in children has been increasing. Early sport specialization, more intense training activity, and increasing participation in competitive sports may have affected to that increasing trend. Diagnosing acute menisci tear in children is based on suggestive clinical and magnetic resonance imaging findings. There are special particulars in immature menisci, due to relatively good vascular supply. Furthermore, growing skeleton makes differences in injury pattern, and a clinician needs to recognize not only meniscus but also potential injuries in growth plates and ligaments, which are usual in connection with pediatric meniscus leasion. Clinical and imaging investigation prior to treatment is crucial, because non-operative care is considerable, to achieve spontaneous healing, especially in peripherial tears of younger children. Second, repair is preferred always as possible, in spite of resection due to high rate of long-term sequelae after partial meniscectomy. High standard preoperative imaging aid in preparing to the meniscus sparing arthroscopic intervention.

Methods: In this current concept article, the clinical considerations of imaging the injured pediatric knee with a suspected meniscus tear and the treatment options by the imaging findings are reviewed.

Level of evidence: level III.

Keywords: Meniscus tear; children and adolescents; imaging; sports injury; treatment options.

Figure 1.

(a) Coronal normal MR imaging appearance of the medial meniscus and the typical bow-tie configuration of the lateral discoid meniscus and (b) sagittal view of the same lateral discoid meniscus as seen in Figure 1(a).

Figure 2.

Longitudinal tear, internal meniscus, and sagittal view.

Figure 3.

Horizontal tear, internal meniscus, and sagittal view.

Figure 4.

Radial tear, lateral meniscus, and sagittal view.

Figure 5.

Complex tear, internal meniscus, and sagittal view.

Figure 6.

Bucket-handle tear, internal meniscus, and coronal view.