Bucket Handle Tears
The most dramatic flap tear is the bucket handle tear, where a significant portion of the meniscus becomes separated from the underlying meniscus and displaces centrally into the notch. In most cases the displaced fragment is large and the classical signs of a significant reduction in the size of the parent meniscus plus the detection of an abnormal structure centrally within the notch allows an easy diagnosis of bucket handle tear. A thin attachment to the parent meniscus is usually preserved.

A variant of this is where a fragment of the posterior third of the meniscus displaces anteriorly rather than centrally. MR images demonstrate an unusual picture with apparent enlargement of the anterior horn compared with the posterior horn. Under normal circumstances, the anterior horn should not be larger than posterior and consequently recognition of this change in morphology is key to the diagnosis of this type of displaced meniscal tear. Enlargement of the anterior horn has also been called pseudo-hypertrophy..
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Anterior flipped meniscus
Flap Tears
The most difficult lesions to diagnose are those that involve a small proportion of the meniscus. These lesions usually start out as parrot beak tears which extend. The fragment of the meniscus can be displaced externally around the rim of the femur or tibia or can be pushed along the meniscus creating a raised portion. The fragments adjacent have displaced posteriorly into a posterior recess.
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Anterior flipped meniscus
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