Stable or not?

“The body says what words cannot”.
– Martha Graham –

The study of a meniscal tear is not easy; the surgeon needs to know if that tear is stable or not, according to the importance of preservation of the meniscus in decreasing the risk of late degenerative changes. Especially in professional sport players the decision to repair a meniscal tear is crucial for all of their sport careers, knowing that a conservative partial meniscectomy should be undertaken to preserve as much meniscal tissue as possible.

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Professional volleyball player with suspected recurrent medial meniscal tear – Sagittal T1w and Ge Stir Mri scans (0.3 Tesla).

Dynamic Mri examination of the same patient – No meniscal instability is noted.

The clinical presentation is always essential but the Mri imaging is important aIso for medical-legal aspects; I usually perform dynamic Mri evaluation during all my standard exams, in order to add as many informations as possible to my final report. There are lots of signs in a standard Mri exams for predicting the tear stability, but I really love the dynamic evaluation; when possible the Mri study in upright position is another great choice for the evaluation of these patients.

I want to share with you the case of a professional football player (32 years old) that came to me for an ultrasound examination of gastrocnemius-semimembranosus chronic bursitis; history of ACL surgical reconstruction and partial medial meniscectomy. During the clinical evaluation an unstable medial meniscectomy was suspected.

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Sagittal T2w Mri scan (0.25 Tesla)

The Mri scan performed both in supine and 80° upright position, confirmed the clinical suspicious. On the video below you can see also the arthroscopic correlation.

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Sagittal T2w  Mri scan (0.25 Tesla).

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