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The ring-shaped meniscus: a case series demonstrating the variation of imaging appearances on MRI

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Abstract

The ring-shaped meniscus (RSM) is a rare meniscal variant in which there is an intermeniscal bridge between the anterior and posterior horns of the meniscus, thus forming a complete ring. The lateral meniscus is more commonly involved than the medial meniscus. Distinguishing an RSM from a bucket handle tear (BHT) with a displaced fragment in the intercondylar notch is challenging and there are reports of negative arthroscopies for suspected BHTs. There are many reports of symptomatic and asymptomatic lateral RSMs diagnosed on MRI in the literature. We report a series of RSMs in six patients, which includes MRI descriptions of two cases of medial RSM and a case of bilateral lateral RSM, which were diagnosed on MRI and have never previously been reported. This study will also describe the various imaging features of a RSM that distinguish it from a displaced BHT. We will also discuss associated rare malformations encountered in our study, such as hypoplastic anterior cruciate ligament and the anomalous insertion of the popliteus tendon onto the posterior horn of a lateral RSM.

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References

  1. Faruch-Bilfield M, Lapegue F, Chiavassa H, Sans N. Imaging of meniscus and ligament injuries of the knee. Diagn Interv Imaging. 2016;97(7–8):749–65.

    Article  Google Scholar 

  2. Dickason JM, Pizzo WD, Blazina ME, Fox JM, Friedman MJ, Snyder SJ. A series of ten discoid medial menisci. Clin Orthop Relat Res. 1982;168:75–9.

    Google Scholar 

  3. Fuji M, Furumatsu T, Miyazawa S, Tanaka T, Inoue H, Kodama Y, et al. Formation of ring-shaped lateral meniscus following anterior cruciate ligament reconstruction: a case report. Int J Surg Case Rep. 2017;31:229–32.

    Article  Google Scholar 

  4. Bailey WH, Blundel GE. An unusual abnormality affecting both knee joints in a child. J Bone Joint Surg Am. 1974;56:814–6.

    Article  CAS  Google Scholar 

  5. Suzuki S, Mita F, Ogishima H. Double-layered lateral meniscus: a newly found anomaly. Arthroscopy. 1991;7:267–71.

    Article  CAS  Google Scholar 

  6. Kim SJ, Lee YT, Choi CH, Kim DW. A partially duplicated discoid lateral meniscus. Arthroscopy. 1998;14(5):518–21.

    Article  CAS  Google Scholar 

  7. Monllau JC, Leon A, Cugat R, Ballester J. Ring-shaped lateral meniscus. Arthroscopy. 1998;14:502–4.

    Article  CAS  Google Scholar 

  8. Fujikawa A, Amma H, Ukegawa Y, Tamura T, Naoi N. MR imaging of meniscal malformations of the knee mimicking displaced bucket-handle tear. Skeletal Radiol. 2002;31:292–5.

    Article  Google Scholar 

  9. Kim YG, Ihn JC, Park SK, Kyung HS. An arthroscopic analysis of lateral meniscal variants and a comparison with MRI findings. Knee Surg Sports Traumatol Arthrosc. 2006;14:20–6.

    Article  Google Scholar 

  10. Singson RD, Feldman F, Staron R, Kiernan H. MR imaging of displaced bucket-handle tear of the medial meniscus. AJR Am J Roentgenol. 1991;156(1):121–4.

    Article  CAS  Google Scholar 

  11. Greis PE, Bardana DD, Holmstrom MC, Burks RT. Meniscal injury. I. Basic science and evaluation. J Am Acad Orthop Surg. 2002;10(3):168–76.

    Article  Google Scholar 

  12. Koukoulias NE, Papastergiou SG. Symptomatic ring-shaped lateral meniscus. MRI findings. BMJ Case Rep. 2011. https://doi.org/10.1136/bcr.10.2011.4914.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Nguyen JC, De Smet AA, Graf BK, Rosas HG. MR imaging-based diagnosis and classification of meniscal tears. Radiographics. 2014;34(4):981–99.

    Article  Google Scholar 

  14. Jadhav SP, More SR, Riascos RF, Lemos DF, Swischuk LE. Comprehensive review of the anatomy, function, and imaging of the popliteus and associated pathologic conditions. Radiographics. 2014;34(2):496–513.

    Article  Google Scholar 

  15. Ryu K, Iriuchishima T, Oshida M, Saito A, Kato Y, Tokuhashi Y, et al. Evaluation of the morphological variations of the meniscus: a cadaver study. Knee Surg Sports Traumatol Arthrosc. 2015;23(1):15–9.

    Article  Google Scholar 

  16. Watson-Jones R. Specimen of internal semilunar cartilage as a complete disc. Proc R Soc Med. 1930;23:1588.

    Google Scholar 

  17. Basmajian JV. A ring-shaped medial semilunar cartilage. J Bone Joint Surg Br. 1957;34:638–9.

    Google Scholar 

  18. Gines-Cespedosa A, Monllau JC. Symptomatic ring-shaped medial meniscus. Clin Anat. 2007;20:994–5.

    Article  Google Scholar 

  19. Soren A. On the etiology of congenital malformation of the meniscus. Arch Orthop Trauma Surg. 1985;104:283–8.

    Article  CAS  Google Scholar 

  20. Le Minor JM. Comparative morphology of the lateral meniscus of the knee in primates. J Anat. 1990;170:161–71.

    PubMed  PubMed Central  Google Scholar 

  21. Arnold MP, Kampen AV. Symptomatic ring-shaped lateral meniscus. Arthroscopy. 2000;16:852–4.

    Article  CAS  Google Scholar 

  22. Esteves C, Castro R, Cadilha R, Raposo F, Melão L. Ring-shaped lateral meniscus with hypoplasic anterior cruciate ligament. Skeletal Radiol. 2015;44(12):1813–8.124.

    Article  Google Scholar 

  23. Soejima T, Kanazawa T, Tabuchi K, Noguchi K, Inoue T, Murakami H. Regeneration of ring-shaped lateral meniscus after partial resection of discoid meniscus with anterior cruciate ligament reconstruction. Int J Surg Case Rep. 2013;4(12):1093–6.

    Article  Google Scholar 

  24. Bisicchia S, Tudisco C. Re-growth of an incomplete discoid lateral meniscus after arthroscopic partial resection in an 11 year-old boy: a case report. BMC Musculoskeletal Disord. 2013;14:285.

    Article  Google Scholar 

  25. Muckenhirn KJ, Kruckeberg BM, Cinque ME, Chahla J, DePhillipo NN, Godin JA, et al. Arthroscopic inside-out repair of a meniscus bucket-handle tear augmented with bone marrow aspirate concentrate. Arthrosc Tech. 2017;6(4):e1221–7.

    Article  Google Scholar 

  26. Hagino T, Ochiai S, Senga S, Yamashita T, Wako M, Ando T, et al. Meniscal tears associated with anterior cruciate ligament injury. Arch Orthop Trauma Surg. 2015;135(12):1701–6.

    Article  Google Scholar 

  27. Han JH, Song JG, Kwon JH, Kang KW, Shah D, Nha KW. Spontaneous healing of a displaced bucket-handle tear of the lateral meniscus in a child. Knee Surg Relat Res. 2015;27(1):65–7.

    Article  Google Scholar 

  28. Krause WR, Pope MH, Johnson RJ, Wilder DG. Mechanical changes in the knee after meniscectomy. J Bone Joint Surg Am. 1976;58:599–604.

    Article  CAS  Google Scholar 

  29. Atay AO, Aydingoz U, Doral NM, Tetik O, Leblebicioglu G. Symptomatic ring-shaped lateral meniscus: magnetic resonance imaging and arthroscopy. Knee Surg Sports Traumatol Arthrosc. 2002;10:280–3.

    Article  Google Scholar 

  30. Simão MN, Nogueira-Barbosa MH. Magnetic resonance imaging in the assessment of meniscal anatomic variants and of the perimeniscal ligamentous anatomy: potential interpretation pitfalls. Radiol Bras. 2011;44(2):117–22.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, Bristol Road South, Northfield, Birmingham, UK

    A. Iqbal, E. McLoughlin, Rajesh Botchu & S. L. James

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  1. A. Iqbal
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  2. E. McLoughlin
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  3. Rajesh Botchu
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Correspondence to Rajesh Botchu.

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Iqbal, A., McLoughlin, E., Botchu, R. et al. The ring-shaped meniscus: a case series demonstrating the variation of imaging appearances on MRI. Skeletal Radiol 49, 281–289 (2020). https://doi.org/10.1007/s00256-019-03277-y

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