MAGNETIC-RESONANCE-IMAGING OF MENISCAL BU CKET-HANDLE TEARS

Purpose: To define MR signs of meniscal bucket-handle tears and evalua te the diagnostic efficiency of this technique. Materials and methods: Retrospective study of 30 patients with a meniscal bucket-handle tear and 30 with a different type of tear, all proven by arthroscopy. The following MR signs of a bucket-handle tear were evaluated : << separat e meniscal fragment >>, << double posterior cruciate ligament >>, << s nake sign >> and << double anterior horn >>. Results: A correct diagno sis of a bucket-handle tear was only made in 18/30 of patients. Severa l of the MR signs were seen in the same patient in 17 cases. A double posterior cruciate ligament was present only in cases of medial menisc us tears. The 12 menisci without these signs, and therefore not diagno sed as bucket-handle tears, were all classified as meniscal tears on t he basis of signal extending to the meniscal surface. Nine of these we re not displaced into the intercondylar notch at arthroscopy. The inte robserver agreement was excellent : kappa = 0.88. Conclusion: The diag nosis of a bucket-handle meniscal tear, if it is displaced, can be mad e when one or more of the four MR evaluated signs are present. Other f orms of meniscal tears are only exceptionally diagnosed as bucket-hand le tears.