Cruciate Ligament Injuries

b Rupture of the anterior cruciate

Suprapatellar Bursitis
Meniscal Tear
Suprapatellar Bursal Effusion

Fig. 8.67a These menisci are normal. b The posterior horn of the medial meniscus is torn. The tear reaches the undersurface of the meniscus (long arrow). There is an effusion in the suprapatellar bursa (small arrows), most likely hemorrhagic in nature. Arising from the posterior joint space, a synovial outpouching can develop filled with joint fluid—the rather frequent Baker cyst (short arrow), which is characteristically located between the tendons of the medial head of the gastrocnemius and the semimembranosus muscle. c Here you see a complete tear of the posterior horn of the meniscus. It is accompanied by a defect of the hyaline cartilage covering the femoral condyle (arrow).

Fig. 8.67a These menisci are normal. b The posterior horn of the medial meniscus is torn. The tear reaches the undersurface of the meniscus (long arrow). There is an effusion in the suprapatellar bursa (small arrows), most likely hemorrhagic in nature. Arising from the posterior joint space, a synovial outpouching can develop filled with joint fluid—the rather frequent Baker cyst (short arrow), which is characteristically located between the tendons of the medial head of the gastrocnemius and the semimembranosus muscle. c Here you see a complete tear of the posterior horn of the meniscus. It is accompanied by a defect of the hyaline cartilage covering the femoral condyle (arrow).

Meniscal tear: This injury is best observed on T2-weighted coronal and sagittal images (Fig. 8.67). The cartilage is best visualized with dedicated cartilage sequences.

Baker cyst: The Baker cyst (Fig. 8.67b) is located postero-medially in the popliteal fossa, between the tendons of the medial head of the gastrocnemius and the semimembranosus muscle. It communicates with the joint via a slitlike connection and may cause compression syndromes or rupture. It is best detected on T2-weighted sequences. It may resolve on its own or is treated surgically.

• Diagnosis: Paul diagnoses a tear in the posterior horn of the medial meniscus in Tush's knee. The posterior me niscus is dislodged ventrally and compresses the ventral meniscus—"kissing menisci" is the nice term for the phenomenon. This is an indication for surgery.

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