Anatomy
The medial meniscus is C shaped. Its central attachments lie on either side of the tibial spines and are outside the central attachments of the lateral meniscus. The medial meniscus has strong peripheral attachments to the deep fibres of the medial collateral ligament and posteriorly to the posterior oblique ligament.

The anterior and posterior horns are well defined. It is asymmetrical in the sagittal plane with the posterior portion of the meniscus being larger and taller than the anterior portion.The lateral meniscus is rounder and its central attachments lie inside those of the medial meniscus. It has weak peripheral attachments making it more mobile and allowing it to move anteroposterior in conjunction with the external rotation at full knee extension. Laterally. The popliteus tendon runs across its posterolateral margin to the popliteus tunnel which lies immediately adjacent to the lateral meniscus.

Sagittal images of the menisci are supplemented by coronal views which are particularly useful for assessing the posterior portions of the meniscal bodies and the posterior attachments of the menisci which are called the meniscal struts. The central portion of the posterior knee is complex and the key structures including the medial and lateral meniscal insertions, the posterior cruciate ligament, the Menisco-Femoral ligaments and a false Menisco-Femoral ligaments should all be identified separated by recesses of the joint.
Normal medial meniscus
Horizontal Tear
Horizontal Tears
Tears are diagnosed when fluid signal reaches an articular surfact on two or more slices. They can be oriented around the three main axes and are thus called

Horizontal Longitudinal and Radial

Horizontal tears are the commonest tears. Characteristics include:

  • Older patients
  • Often asymptomatic
  • Can be associated with meniscal cysts

Often occur in association with cartilage disease.

MRI reports can include elements including:
  • Zone of involvement (1 peripheral to 3 central rim)
  • Location (anterior / Middle / Posterior)
  • Length of tear
  • CState of surrounding meniscus
  • Location around popliteus
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    Post Operative Meniscus
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