meniscocapsular separation

Meniscal ramp
lesions: an illustrated review. Type 1 meniscal ramp lesion MRI Case. Sagittal (a) and axial T2-weighted fat-suppressed images show meniscocapsular tear (arrow) with tibial bone bruise, and the extension of meniscocapsular junction edema (arrowheads)
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Meniscal ramp
lesions: an illustrated review. Type 1 ramp lesion illustration, defined as meniscocapsular ligament tear
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Meniscal ramp
lesions: an illustrated review. Type 4B meniscal ramp lesion illustration, defined as complete meniscocapsular junction tear
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Meniscal ramp
lesions: an illustrated review. Type 4B meniscal ramp lesion MRI case. Sagittal (a) T2-weighted fat-suppressed MR image shows a type IV ramp lesion, with a complete meniscocapsular disruption of the posterior horn of medial meniscus. Axial (b) image shows a cross-sectional view of the extensive meniscocapsular disruption
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Meniscocapsular separation refers to detachment of the meniscus from its capsular attachments. It is an uncommon injury.

Clinical presentation

Clinical findings are nonspecific and can include pain, instability, and joint effusion.

Pathology

Location
  • it is more common in the medial (more frequently posterior horn region ) than in the lateral compartment of the knee
    • ramp lesions are a specific type of meniscocapsular injury associated with ACL-deficient knees
  • meniscofemoral detachment is more common than meniscotibial detachment
Associations

While it can uncommonly occur in isolation, it is more often associated with other ligamentous injuries.

Radiographic features

MRI

Meniscocapsular separation is usually diagnosed arthroscopically and the positive predictive value (PPV) of MRI has been traditionally described as being low (as low as 9% medially and 13% laterally).

Low predictive value MRI findings that have been correlated with meniscocapsular separation include :

  • interposition of fluid between the meniscus and the medial collateral ligament
  • meniscal corner tears: according to one study had a PPV of 0% medially and 50% laterally
  • perimeniscal fluid
  • meniscofemoral and meniscotibial extension tears
  • irregular meniscal outline
  • increased distance between the meniscus and the medial collateral ligament
  • visualization of fluid from the superior all the way to the inferior end of the meniscus has been described as a more suggestive feature

On MR arthrography meniscocapsular separations have been correlated with interposition of contrast medium between the meniscus and the medial collateral ligament.

Treatment and prognosis

It may heal after conservative treatment or after re-suturing the meniscus into the capsule.

Complications

Potential complications include:

Differential diagnosis

On MRI consider a normal menisco-synovial recess / perimeniscal recess .

Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu menisko-kapsuläre Separation:
meniskokapsuläre
Verbindung
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Rampenläsion
Meniskus
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