Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Please confirm action

You are done for today with this topic.

Would you like to start learning session with this topic items scheduled for future?

Updated: Oct 30 2021

Discoid Meniscus

  • Summary
    • A discoid meniscus is the abnormal development of the meniscus leading to a hypertrophic and discoid shaped meniscus.
    • Diagnosis can be suspected on radiographs with (squaring of lateral condyle with cupping of lateral tibial plateau) but require MRI for confirmation (3 or more 5mm sagittal images with meniscal continuity).
    • Treatment is generally observation for patients who are asymptomatic. Arthroscopic meniscectomy and saucerization may be indicated for patients with continued pain and mechanical symptoms.
  • Epidemiology
    • Incidence
      • common
        • present in 3-5% of population
    • Anatomic location
      • usually lateral meniscus involved
      • 25% bilateral
  • Etiology
    • Pathophysiology
      • failure of apoptosis in utero
  • Classification
      • Watanabe Classification
      • Type I
      • Complete
      • Type II
      • Incomplete
      • Type III
      • Wrisberg (lack of posterior meniscotibial attachment to tibia)
  • Presentation
    • Symptoms
      • pain, clicking, mechanical locking
      • often becomes symptomatic in adolescence
    • Physical exam
      • mechanical symptoms most pronounced in extension
  • Imaging
    • Radiographs
      • recommended views
        • AP and lateral of knee
        • widened joint space (up to 11mm)
        • squaring of lateral condyle
        • cupping of lateral tibial plateau
        • hypoplastic lateral intercondylar spine
    • MRI
      • indications
        • study of choice for suspected symptomatic meniscal pathology
      • findings
        • diagnosis can be made with 3 or more 5mm sagittal images with meniscal continuity ("bow-tie sign")
        • sagittal MRI will show abnormally thick and flat meniscus
        • coronal MRI will show thick and flat meniscal tissue extending across entire lateral compartment
        • Symptomatic cases may reveal underlying meniscus tear
  • Treatment
    • Nonoperative
      • observation
        • indications
          • asymptomatic discoid meniscus without tears
    • Operative
      • partial meniscectomy and saucerization
        • indications
          • pain and mechanical symptoms
          • meniscal tear or meniscal detachment
        • technique
          • obtain anatomic looking meniscus with debridement
          • repair meniscus if detached (Wrisberg variant)
        • meniscal instability is frequently present
          • recent literature suggest anterior horn instability is most common
1 of 2
1 of 19
Private Note

Attach Treatment Poll
Treatment poll is required to gain more useful feedback from members.
Please enter Question Text
Please enter at least 2 unique options
Please enter at least 2 unique options
Please enter at least 2 unique options