A characteristic MRI finding to diagnose a partial tear of the medial meniscus posterior root: an ocarina sign

Abstract Background Diagnosing partial tears of the medial meniscus (MM) posterior root is difficult. The aim of this study was to evaluate diagnostic values involved in conventional magnetic resonance imaging (MRI) features of MM posterior root tears (MMPRTs) and find other MRI-based findings in pa...

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Main Authors: Takayuki Furumatsu, Takaaki Hiranaka, Keisuke Kintaka, Yuki Okazaki, Naohiro Higashihara, Masanori Tamura, Toshifumi Ozaki
Format: Article
Language:English
Published: BMC 2021-10-01
Series:Knee Surgery & Related Research
Subjects:
Online Access:https://doi.org/10.1186/s43019-021-00120-4
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author Takayuki Furumatsu
Takaaki Hiranaka
Keisuke Kintaka
Yuki Okazaki
Naohiro Higashihara
Masanori Tamura
Toshifumi Ozaki
author_facet Takayuki Furumatsu
Takaaki Hiranaka
Keisuke Kintaka
Yuki Okazaki
Naohiro Higashihara
Masanori Tamura
Toshifumi Ozaki
author_sort Takayuki Furumatsu
collection DOAJ
description Abstract Background Diagnosing partial tears of the medial meniscus (MM) posterior root is difficult. The aim of this study was to evaluate diagnostic values involved in conventional magnetic resonance imaging (MRI) features of MM posterior root tears (MMPRTs) and find other MRI-based findings in patients with partial MMPRTs. Methods Eighteen patients who had arthroscopically confirmed partial MMPRTs were included. As a control, 18 patients who underwent partial meniscectomy for other types of MM tears were evaluated. Isolated partial MMPRTs were classified into the following three types: type A, accurate partial stable tear (cleavage < 1/2 of root width); type B, bridged unstable root tear (cleavage ≥ 1/2 of root width); type C, complex horn tear expanded to the root. Conventional MRI-based findings of MMPRTs were evaluated between two groups (n = 23). Posterior root irregularity, bone marrow spot, and ocarina-like appearance showing several condensed circles in triangular meniscal horn (ocarina sign) were also evaluated. Results Posterior root irregularity and bone marrow spot were frequently observed in the partial MMPRTs (47.8%), compared with the other MM tears (P = 0.007 and 0.023, respectively). The ocarina sign was detected in 69.6% of patients with partial MMPRTs. A significant difference between two groups was observed in a positive ratio of ocarina sign (P < 0.001). Types A, B, and C of the partial tear/damage were observed in three, eight, and seven patients, respectively. The ocarina sign was the most common MRI finding in each type of partial MMPRT. Conclusions This study demonstrated that a characteristic MRI finding, “ocarina sign,” was frequently observed in patients with partial tear/damage of the MM posterior root. The ocarina sign was the most common MRI finding in several types of partial MMPRTs. Our results suggest that the ocarina sign may be useful to diagnose unnoticed partial MMPRTs. Level of evidence: IV, retrospective comparative study.
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spelling doaj.art-3ad892f336924fd5a787e965d69f6dde2022-12-21T20:16:45ZengBMCKnee Surgery & Related Research2234-24512021-10-013311910.1186/s43019-021-00120-4A characteristic MRI finding to diagnose a partial tear of the medial meniscus posterior root: an ocarina signTakayuki Furumatsu0Takaaki Hiranaka1Keisuke Kintaka2Yuki Okazaki3Naohiro Higashihara4Masanori Tamura5Toshifumi Ozaki6Department of Orthopaedic Surgery, Okayama University HospitalDepartment of Orthopaedic Surgery, Okayama University HospitalDepartment of Orthopaedic Surgery, Okayama University HospitalDepartment of Orthopaedic Surgery, Okayama University HospitalDepartment of Orthopaedic Surgery, Okayama University HospitalDepartment of Orthopaedic Surgery, Okayama University HospitalDepartment of Orthopaedic Surgery, Okayama University HospitalAbstract Background Diagnosing partial tears of the medial meniscus (MM) posterior root is difficult. The aim of this study was to evaluate diagnostic values involved in conventional magnetic resonance imaging (MRI) features of MM posterior root tears (MMPRTs) and find other MRI-based findings in patients with partial MMPRTs. Methods Eighteen patients who had arthroscopically confirmed partial MMPRTs were included. As a control, 18 patients who underwent partial meniscectomy for other types of MM tears were evaluated. Isolated partial MMPRTs were classified into the following three types: type A, accurate partial stable tear (cleavage < 1/2 of root width); type B, bridged unstable root tear (cleavage ≥ 1/2 of root width); type C, complex horn tear expanded to the root. Conventional MRI-based findings of MMPRTs were evaluated between two groups (n = 23). Posterior root irregularity, bone marrow spot, and ocarina-like appearance showing several condensed circles in triangular meniscal horn (ocarina sign) were also evaluated. Results Posterior root irregularity and bone marrow spot were frequently observed in the partial MMPRTs (47.8%), compared with the other MM tears (P = 0.007 and 0.023, respectively). The ocarina sign was detected in 69.6% of patients with partial MMPRTs. A significant difference between two groups was observed in a positive ratio of ocarina sign (P < 0.001). Types A, B, and C of the partial tear/damage were observed in three, eight, and seven patients, respectively. The ocarina sign was the most common MRI finding in each type of partial MMPRT. Conclusions This study demonstrated that a characteristic MRI finding, “ocarina sign,” was frequently observed in patients with partial tear/damage of the MM posterior root. The ocarina sign was the most common MRI finding in several types of partial MMPRTs. Our results suggest that the ocarina sign may be useful to diagnose unnoticed partial MMPRTs. Level of evidence: IV, retrospective comparative study.https://doi.org/10.1186/s43019-021-00120-4Medial meniscusPosterior rootPartial tearMagnetic resonance imagingOcarina sign
spellingShingle Takayuki Furumatsu
Takaaki Hiranaka
Keisuke Kintaka
Yuki Okazaki
Naohiro Higashihara
Masanori Tamura
Toshifumi Ozaki
A characteristic MRI finding to diagnose a partial tear of the medial meniscus posterior root: an ocarina sign
Knee Surgery & Related Research
Medial meniscus
Posterior root
Partial tear
Magnetic resonance imaging
Ocarina sign
title A characteristic MRI finding to diagnose a partial tear of the medial meniscus posterior root: an ocarina sign
title_full A characteristic MRI finding to diagnose a partial tear of the medial meniscus posterior root: an ocarina sign
title_fullStr A characteristic MRI finding to diagnose a partial tear of the medial meniscus posterior root: an ocarina sign
title_full_unstemmed A characteristic MRI finding to diagnose a partial tear of the medial meniscus posterior root: an ocarina sign
title_short A characteristic MRI finding to diagnose a partial tear of the medial meniscus posterior root: an ocarina sign
title_sort characteristic mri finding to diagnose a partial tear of the medial meniscus posterior root an ocarina sign
topic Medial meniscus
Posterior root
Partial tear
Magnetic resonance imaging
Ocarina sign
url https://doi.org/10.1186/s43019-021-00120-4
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