Meniscal tears with fragments displaced in notch and recesses of knee: MR imaging with arthroscopic comparison

PURPOSE: To retrospectively evaluate magnetic resonance (MR) imaging for the depiction of meniscal tears with partially detached meniscal fragments displaced in the intercondylar notch or in the meniscal recesses of the knee. MATERIALS AND METHODS: The institutional review board required neither its approval nor informed patient consent for the retrospective review of patient data; however, informed patient consent had been obtained before the MR imaging examinations were performed. The presence of meniscal tears with notch and recess fragments was determined at MR imaging and at subsequent arthroscopy in 101 consecutive knees to determine the value of MR imaging for the depiction of these lesions. Initial reports were reviewed to evaluate results of initial interpretations. MR images were retrospectively analyzed to determine the value of several MR image signs for the detection of displaced tears with notch or recess fragments. RESULTS: At arthroscopy, 37 (41%) of 91 torn menisci had partially detached fragments. Twenty-six torn menisci had notch fragments, and 14 had recess fragments; three torn menisci had one notch and one recess fragment each. At initial MR image analysis, 38 (36%) of 105 torn menisci had partially detached fragments. Twenty-eight torn menisci had notch fragments, and 13 had recess fragments; one torn meniscus had two recess fragments, and three torn menisci had one notch and one recess fragment each. At initial analysis, sensitivities and specificities were, respectively, 69% and 94% for detection of tears with notch fragments and 71% and 98% for detection of tears with recess fragments. At retrospective analysis of sagittal MR images, the presence of at least one sign indicative of meniscal tear with a notch fragment had sensitivities and specificities, respectively, of 65% and 78% for observer 1 and 77% and 73% for observer 2. The presence of at least one sign indicative of a meniscal tear with a recess fragment had sensitivities and specificities, respectively, of 64% and 77% for observer 1 and 64% and 76% for observer 2. CONCLUSION: Meniscal tears with notch and recess fragments are frequently seen at arthroscopy and can be depicted at knee MR imaging with moderate sensitivity and high specificity. (C) RSNA, 2005.