Intra-substance meniscal changes and their clinical significance: a meta-analysis

Rani Ahmad

doi:10.1038/s41598-021-83181-5

Abstract

The degeneration of radial tie fibres of the central meniscal layer, and thinning of its lamellar layer results in increased intensity signals on magnetic resonance imaging, making it difficult to differentiate from true meniscal tear. This study aimed to assess the rate of encountered MRI grades 1 and 2 intrasubstance meniscal changes, and to set guidelines to report these changes based on predicted clinical outcome. A systematic review approach was employed using search engines, libraries, and databases (Google Scholar, ERIC, PubMed, and Medline) to search for scholarly sources on meniscal lesions and their significance in MRI published between 1 January 2000 and 30 June 2019. It retrieved 2750 abstracts, out of which 2738 were excluded and 13 studies meeting inclusion criteria were meta-analysed. It found an association between intrasubstances meniscal changes and outcomes. It resulted that intrasubstance meniscal changes were preservable through the protective functioning of the meniscus. Other than weight gain, no other significant risk factor of developing true meniscal tears later in life was found. It is important to examine intrasubstance meniscal change when patients suffer from mechanical meniscal symptoms especially in old age.

Highlights

Magnetic resonance imaging (MRI) is a common radiological technique used to diagnose or examine the knee joint
Normal meniscus for the adult patient usually appears as a low signal intensity structure in T2 and PD imaging sequences, subtle high signal intensity may be found within the substance of the meniscus
The subtle increase in signal intensity contributes to the normal content of the meniscus as well as the existence of meniscal vessels that is observed among young p atients[9]

Summary

Introduction

Magnetic resonance imaging (MRI) is a common radiological technique used to diagnose or examine the knee joint. The wedge-shape of the meniscus renders multiple and complex functions by stabilizing the femoral condyle in its articulation with the flat surface of the tibial p lateau[3]. This structure enables the conversion of vertical compressive forces into horizontal hoop stress. Direct trauma may lead to meniscal tear after the degeneration of the meniscus. The T2-weighted and PD-weighted sequences are the most commonly used in coronal and sagittal planes. These sequences are highly sensitive to myxoid degeneration and edema, which can occur during meniscal tears. Based on Beals et al, meniscal changes are graded into three categories[10]

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