Pseudoradial Tear of the Medial Meniscus: A Relatively Common Potential Pitfall
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Purpose : To determine the incidence of truncated triangle appearance of anterior horn (AH) to body of medial meniscus(MM) and determine its clinical significance. Materials and Methods: IRB approval was obtained, and informed consent waived for this study. The criteria of “pseudoradialtear” was truncated triangle appearance of the tip of AH to body of MM on one or more coronal images with adjacentfluid signal intensity at the blunted tip. Two musculoskeletal radiologists retrospectively evaluated 485 knee MRimages independently for the presence and number of sections with “pseudoradial tear” of AH to body of MM using protondensity-weighted coronal MR images. Inter-and intraobserver agreement was calculated using kappa coefficients. Medical records were reviewed for arthroscopic correlation. Results: A pseudoradial tear in the AH to body of MM was present in 381 (78.6%) patients. Locations were 112 in AH(29.4%), 143 in AH to body (37.5%), and 126 in body (33.1%). Number of consecutive sections of pseudoradial tearwere 1 in 100 (26.2%), 2 in 164 (43.0%), 3 in 94 (24.7%), 4 in 21 (5.5%), and 5 in 2 (0.5%). Interobserver agreementwas 0.99 for presence and 0.43 for number of sections of pseudoradial tear. Arthroscopies were performed in 96 patientsand none of the pseudoradial tears were proven as true radial tears on arthroscopy. Conclusion: Pseudoradial tears are frequently seen in AH to body of MM on coronal MR images and may be another pitfallthat a radiologist needs to be aware of and be able to differentiate from true radial tear.
Abstract
Purpose : To determine the incidence of truncated triangle appearance of anterior horn (AH) to body of medial meniscus(MM) and determine its clinical significance. Materials and Methods: IRB approval was obtained, and informed consent waived for this study. The criteria of “pseudoradialtear” was truncated triangle appearance of the tip of AH to body of MM on one or more coronal images with adjacentfluid signal intensity at the blunted tip. Two musculoskeletal radiologists retrospectively evaluated 485 knee MRimages independently for the presence and number of sections with “pseudoradial tear” of AH to body of MM using protondensity-weighted coronal MR images. Inter-and intraobserver agreement was calculated using kappa coefficients. Medical records were reviewed for arthroscopic correlation. Results: A pseudoradial tear in the AH to body of MM was present in 381 (78.6%) patients. Locations were 112 in AH(29.4%), 143 in AH to body (37.5%), and 126 in body (33.1%). Number of consecutive sections of pseudoradial tearwere 1 in 100 (26.2%), 2 in 164 (43.0%), 3 in 94 (24.7%), 4 in 21 (5.5%), and 5 in 2 (0.5%). Interobserver agreementwas 0.99 for presence and 0.43 for number of sections of pseudoradial tear. Arthroscopies were performed in 96 patientsand none of the pseudoradial tears were proven as true radial tears on arthroscopy. Conclusion: Pseudoradial tears are frequently seen in AH to body of MM on coronal MR images and may be another pitfallthat a radiologist needs to be aware of and be able to differentiate from true radial tear.
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