Anatomy, magnetic resonance and arthroscopy of the popliteal hiatus of the knee: normal aspect and pathological conditions

The popliteal hiatus is a complex region, formed by the confluence of various structures connecting the meniscus, popliteal tendon, tibia and fibula. The main structures that can be found are the three popliteomeniscal fascicles (anterior, postero-inferior and postero-superior), the lateral and posterior meniscotibial ligaments, the popliteofibular ligament and the meniscofibular fascicle. These structures can be identified in most cases using magnetic resonance imaging, and their ‘static’ assessment can be performed. Arthroscopic assessment is useful in identifying and testing ‘dynamically’ the integrity of the structures around the popliteal hiatus. Injuries or abnormalities of the popliteal hiatus and its structures could result in meniscal hypermobility and subluxation; however, these injuries are often unrecognized. Possible abnormalities in this region, apart from the well-known bucket-handle meniscal tear, are the Wrisberg Type III discoid meniscus, and meniscal fascicles tears. Cite this article: EFORT Open Rev 2021;6:941-954. DOI: 10.1302/2058-5241.6.200089

Download Full-text

Unusual Pattern of Bucket-Handle, Medial Meniscal Tear in Magnetic Resonance Imaging

Military Medicine ◽

10.7205/milmed.173.11.1142 ◽

2008 ◽

Vol 173 (11) ◽

pp. 1142-1144 ◽

Cited By ~ 1

Author(s):

Elizabeth A. Ballard ◽

Scot E. Campbell

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Meniscal Tear ◽

Resonance Imaging ◽

Unusual Pattern ◽

Medial Meniscal Tear ◽

Bucket Handle

Download Full-text

Magnetic resonance imaging of the knee

10.1093/med/9780199550647.003.008003 ◽

2011 ◽

Author(s):

Ryan Shulman ◽

Adrian Wilson ◽

Delia Peppercorn

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Clinical Examination ◽

Meniscal Tear ◽

Lateral Collateral Ligament ◽

Resonance Imaging ◽

Popliteofibular Ligament ◽

Bone Bruising ◽

Tibial Translation ◽

Painful Knee

♦ ACL tear: abnormal fibres, tibial translation, PCL/patella tendon buckling, bone bruising♦ Meniscal tear: signal change to free edge♦ Bone bruising:• Reticular—not continuous subarticular bone• Geographic—extends to subarticular bone♦ Posterolateral corner:• Oblique slices through fibular head• Consists of lateral collateral ligament, popliteus, popliteofibular ligament, and arcuate complex.Magnetic resonance imaging (MRI) has revolutionized the investigation and treatment of the painful knee. It is non-invasive and avoids patient exposure to ionizing radiation. MRI has the advantage of establishing diagnoses in a painful knee without the morbidity of surgical intervention. It is now widely available and has moved from a simple diagnostic adjunct into a key planning tool. It offers improved management of theatre resources and it allows for more accurate planning of postoperative rehabilitation.The role of MRI in management of the injured knee is determined by its cost-effectiveness and its ability to augment the diagnostic accuracy of clinical examination. Accuracy of clinical examination by specialist orthopaedic surgeons is comparable to MRI when interpreted by specialist radiologists (Table 8.3.1). Increasingly, MRI has been shown to be cost neutral. Whilst costs are high, diagnostic information reduces the need for unnecessary surgery.

Download Full-text

Free Medial Meniscal Fragment Which Mimics the Dislocated Bucket-Handle Tear on MRI

Case Reports in Orthopedics ◽

10.1155/2014/647491 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Faik Türkmen ◽

İsmail Hakkı Korucu ◽

Cem Sever ◽

Mehmet Demirayak ◽

Gani Goncü ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Diagnostic Tool ◽

Meniscal Tear ◽

Intercondylar Notch ◽

Resonance Imaging ◽

Magnetic Resonance Imaging Mri ◽

Bucket Handle Tear ◽

Bucket Handle ◽

Bow Tie

The bucket-handle meniscal tear is a specific type of meniscal injuries which has specific signs on MRI. An attached fragment displaced away from the meniscus with any type of tear causes bucket-handle tear of the meniscus. Magnetic resonance imaging (MRI) is the most commonly used diagnostic tool for meniscal injuries. We present a case of free medial meniscal fragment which mimics the dislocated bucket-handle tear on MRI. The presence of “fragment within the intercondylar notch sign” and “the absence of the bow tie sign” may be an indication of a free meniscal fragment. This should be considered during diagnosis.

Download Full-text

Focus on Diffusion MR Investigations of Musculoskeletal Tissue to Improve Osteoporosis Diagnosis: A Brief Practical Review

BioMed Research International ◽

10.1155/2015/948610 ◽

2015 ◽

Vol 2015 ◽

pp. 1-10 ◽

Cited By ~ 6

Author(s):

Silvia Capuani ◽

Guglielmo Manenti ◽

Riccardo Iundusi ◽

Umberto Tarantino

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Cancellous Bone ◽

Diffusion Magnetic Resonance Imaging ◽

Resonance Imaging ◽

Huge Number ◽

Musculoskeletal Tissue ◽

Diffusion Mr ◽

Pathological Conditions

Nowadays, a huge number of papers have documented the ability of diffusion magnetic resonance imaging (D-MRI) to highlight normal and pathological conditions in a variety of cerebral, abdominal, and cardiovascular applications. To date, however, the role of D-MRI to investigate musculoskeletal tissue, specifically the cancellous bone, has not been extensively explored. In order to determine potentially useful applications of diffusion techniques in musculoskeletal investigation, D-MRI applications to detect osteoporosis disease were reviewed and further explained.

Download Full-text

The Magnetic Resonance Imaging Appearance of Individual Structures of the Posterolateral Knee

The American Journal of Sports Medicine ◽

10.1177/03635465000280020901 ◽

2000 ◽

Vol 28 (2) ◽

pp. 191-199 ◽

Cited By ~ 199

Author(s):

Robert F. LaPrade ◽

Thomas J. Gilbert ◽

Timothy S. Bollom ◽

Fred Wentorf ◽

Gregory Chaljub

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Biceps Femoris ◽

Surgical Reconstruction ◽

Iliotibial Band ◽

Resonance Imaging ◽

Popliteofibular Ligament ◽

Imaging Appearance ◽

Magnetic Resonance Imaging Appearance ◽

Lateral Capsular Ligament

The purpose of this study was to contrast the magnetic resonance imaging appearance of uninjured components of the posterolateral knee with that of injured structures, and to assess the accuracy of magnetic resonance imaging in identifying posterolateral knee complex injuries. Thin-slice coronal oblique T1-weighted images through the entire fibular head were used to identify the posterolateral structures in seven uninjured knees. The appearance of corresponding grade III injuries to these structures was identified prospectively in 20 patients and verified at the time of surgical reconstruction. The sensitivity, specificity, and accuracy of imaging for the most frequently injured posterolateral knee structures in this series were as follows: iliotibial band-deep layer (91.7%, 100%, and 95%), short head of the biceps femoris-direct arm (81.3%, 100%, and 85%), short head of the biceps femoris-anterior arm (92.9%, 100%, and 95%), midthird lateral capsular ligament-meniscotibial (93.8%, 100%, and 95%), fibular collateral ligament (94.4%, 100%, and 95%), popliteus origin on femur (93.3%, 80%, and 90%), popliteofibular ligament (68.8%, 66.7%, and 68%), and the fabellofibular ligament (85.7%, 85.7%, and 85.7%). Magnetic resonance imaging of the knee was accurate in the identification of these injuries.

Download Full-text