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Review Question - QID 1052

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QID 1052 (Type "1052" in App Search)
An 8-year-old boy was playing at school and took a direct blow to his knee causing pain and swelling. His pediatrician ordered an MRI which is shown in Figure A. The patient was referred to your office for a consultation. He denies any past history of pain, clicking, or locking. His knee exam is benign. Radiographs of the knee in your office are normal. What course of action will you recommend?
  • A

Surgical debridement and repair

4%

136/3194

Ligamentous reconstruction

1%

32/3194

Casting in 45 degrees of flexion

2%

75/3194

Knee immobilizer and non weight bearing for 6 weeks

5%

148/3194

Observation

87%

2790/3194

  • A

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The clinical presentation and MRI are consistent with an asymptomatic lateral discoid meniscus without evidence of tear. No intervention is indicated for asymptomatic discoid menisci. When these are symptomatic, surgical saucerization and possible repair are indicated.

Klingele et al reviewed a series of 112 surgically treated patients and found that 28% were unstable, and 69% had an associated meniscus tear.

Ogut et al reported their follow-up on 11 surgically treated discoid mensici, and had 82% excellent results and 18% good results. Davidson et al reported their results in 32 children who underwent partial, complete or no excision of the discoid meniscus, with 16 excellent, 10 good, 6 fair and 4 poor results.

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