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Postoperative Meniscus: Assessment at Dual–Detector Row Spiral CT Arthrography of the Knee¹

¹ From the Departments of Radiology (C.M., B.C.V.B., F.E.L., B.M., J.M.) and Orthopedic Surgery (P.P., J.E.D.), Cliniques universitaires St Luc, Université Catholique de Louvain, 10 av Hippocrate, 1200 Brussels, Belgium. Received May 17, 2002; revision requested July 12; final revision received November 27; accepted January 14, 2003. Address correspondence to B.C.V.B. (e-mail: vandeberg@rdgn.ucl.ac.be).

View larger version (114K): [in a new window]   Figure 1a. Spiral CT arthrographic images of a normal postoperative meniscus in the right knee of a 56-year-old man who underwent partial medial meniscectomy 2 years prior. (a) Sagittal oblique reformation shows that the posterior horn (arrow) of the medial meniscus is small. There is no intrameniscal contrast material. (b) Coronal reformation shows a similar appearance of the medial meniscus (arrow). The medial meniscus was considered normal at both initial and retrospective interpretations and at second-look arthroscopy.

View larger version (113K): [in a new window]   Figure 1b. Spiral CT arthrographic images of a normal postoperative meniscus in the right knee of a 56-year-old man who underwent partial medial meniscectomy 2 years prior. (a) Sagittal oblique reformation shows that the posterior horn (arrow) of the medial meniscus is small. There is no intrameniscal contrast material. (b) Coronal reformation shows a similar appearance of the medial meniscus (arrow). The medial meniscus was considered normal at both initial and retrospective interpretations and at second-look arthroscopy.

View larger version (102K): [in a new window]   Figure 2a. Spiral CT arthrographic images of full-thickness meniscal tear in the left knee of a 47-year-old man who underwent partial medial meniscectomy 6 months prior. (a) Sagittal oblique reformation shows that the posterior horn of the medial meniscus is small, with irregular contour. A full-thickness vertical tear (black arrow) is visible. Damage of the hyaline cartilage (white arrow) also can be detected. (b) Medial sagittal oblique reformation shows the extent of the vertical tear in the body of the meniscus (arrow). (c) Coronal reformation shows the full-thickness tear involving the posterior horn of the medial meniscus (arrows). At second-look arthroscopy, the medial meniscus was confirmed torn and was resected.

View larger version (98K): [in a new window]   Figure 2b. Spiral CT arthrographic images of full-thickness meniscal tear in the left knee of a 47-year-old man who underwent partial medial meniscectomy 6 months prior. (a) Sagittal oblique reformation shows that the posterior horn of the medial meniscus is small, with irregular contour. A full-thickness vertical tear (black arrow) is visible. Damage of the hyaline cartilage (white arrow) also can be detected. (b) Medial sagittal oblique reformation shows the extent of the vertical tear in the body of the meniscus (arrow). (c) Coronal reformation shows the full-thickness tear involving the posterior horn of the medial meniscus (arrows). At second-look arthroscopy, the medial meniscus was confirmed torn and was resected.

View larger version (92K): [in a new window]   Figure 2c. Spiral CT arthrographic images of full-thickness meniscal tear in the left knee of a 47-year-old man who underwent partial medial meniscectomy 6 months prior. (a) Sagittal oblique reformation shows that the posterior horn of the medial meniscus is small, with irregular contour. A full-thickness vertical tear (black arrow) is visible. Damage of the hyaline cartilage (white arrow) also can be detected. (b) Medial sagittal oblique reformation shows the extent of the vertical tear in the body of the meniscus (arrow). (c) Coronal reformation shows the full-thickness tear involving the posterior horn of the medial meniscus (arrows). At second-look arthroscopy, the medial meniscus was confirmed torn and was resected.

View larger version (115K): [in a new window]   Figure 3a. Spiral CT arthrographic images of displaced meniscal tear in the right knee of a 31-year-old man who underwent partial medial meniscectomy 12 months prior. (a) Sagittal oblique reformation shows contrast material filling (open arrow) in the posterior horn of the medial meniscus. The extent of the penetration is limited and suggests a small partial-thickness tear. The irregularity of the upper surface of the anterior horn (solid arrow) is due to an overlying synovial fat pad. (b) Lateral sagittal oblique reformation shows a meniscal fragment (white arrow) attached to the lateral aspect (black arrow) of the medial meniscus. (c) Coronal reformation shows the displaced meniscal fragment (arrow) in the posterior aspect of the intercondylar space. The presence of a displaced meniscal fragment indicates residual or recurrent meniscal tear. At second-look arthroscopy, a displaced tear of the medial meniscus was found.

View larger version (113K): [in a new window]   Figure 3b. Spiral CT arthrographic images of displaced meniscal tear in the right knee of a 31-year-old man who underwent partial medial meniscectomy 12 months prior. (a) Sagittal oblique reformation shows contrast material filling (open arrow) in the posterior horn of the medial meniscus. The extent of the penetration is limited and suggests a small partial-thickness tear. The irregularity of the upper surface of the anterior horn (solid arrow) is due to an overlying synovial fat pad. (b) Lateral sagittal oblique reformation shows a meniscal fragment (white arrow) attached to the lateral aspect (black arrow) of the medial meniscus. (c) Coronal reformation shows the displaced meniscal fragment (arrow) in the posterior aspect of the intercondylar space. The presence of a displaced meniscal fragment indicates residual or recurrent meniscal tear. At second-look arthroscopy, a displaced tear of the medial meniscus was found.

View larger version (106K): [in a new window]   Figure 3c. Spiral CT arthrographic images of displaced meniscal tear in the right knee of a 31-year-old man who underwent partial medial meniscectomy 12 months prior. (a) Sagittal oblique reformation shows contrast material filling (open arrow) in the posterior horn of the medial meniscus. The extent of the penetration is limited and suggests a small partial-thickness tear. The irregularity of the upper surface of the anterior horn (solid arrow) is due to an overlying synovial fat pad. (b) Lateral sagittal oblique reformation shows a meniscal fragment (white arrow) attached to the lateral aspect (black arrow) of the medial meniscus. (c) Coronal reformation shows the displaced meniscal fragment (arrow) in the posterior aspect of the intercondylar space. The presence of a displaced meniscal fragment indicates residual or recurrent meniscal tear. At second-look arthroscopy, a displaced tear of the medial meniscus was found.