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Meniscal Vertical Longitudinal Tear
Andrew Sonin, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Vertical longitudinal tear (VLT)
            • Synonyms

              • Longitudinal tear
            • Definitions

              • Tear along vertical long axis of meniscus
              • Meniscal red zone: Peripheral 1/3 of meniscus; vascular zone
              • Meniscal red-white junction: Middle 1/3 of meniscus
              • Meniscal white zone: Central 1/3 of meniscus, near free edge
              • Meniscectomy: Resection of portion or all (rarely) of torn meniscus

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Consider

                                  • Image Interpretation Pearls

                                    • Reporting Tips

                                      Selected References

                                      1. Shelbourne KD et al: Evaluation of peripheral vertical nondegenerative medial meniscus tears treated with trephination alone at the time of anterior cruciate ligament reconstruction. Arthroscopy. 31(12):2411-6, 2015
                                      2. Kijowski R et al: MRI characteristics of healed and unhealed peripheral vertical meniscal tears. AJR Am J Roentgenol. 202(3):585-92, 2014
                                      3. Nguyen JC et al: MR imaging-based diagnosis and classification of meniscal tears. Radiographics. 34(4):981-99, 2014
                                      4. Davis KW et al: Magnetic resonance imaging and arthroscopic appearance of the menisci of the knee. Clin Sports Med. 32(3):449-75, 2013
                                      5. De Smet AA: How I diagnose meniscal tears on knee MRI. AJR Am J Roentgenol. 199(3):481-99, 2012
                                      6. Muriuki MG et al: Changes in tibiofemoral contact mechanics following radial split and vertical tears of the medial meniscus an in vitro investigation of the efficacy of arthroscopic repair. J Bone Joint Surg Am. 93(12):1089-95, 2011
                                      7. Alatakis S et al: MR imaging of meniscal and cartilage injuries of the knee. Magn Reson Imaging Clin N Am. 17(4):741-56, vii, 2009
                                      8. De Smet AA et al: MR diagnosis of posterior root tears of the lateral meniscus using arthroscopy as the reference standard. AJR Am J Roentgenol. 192(2):480-6, 2009
                                      9. DeHaan A et al: Evaluation of success of a meniscus repair device for vertical unstable medial meniscus tears in ACL-reconstructed knees. Orthopedics. 32(4), 2009
                                      10. Fetzer GB et al: Potential market for new meniscus repair strategies: evaluation of the MOON cohort. J Knee Surg. 22(3):180-6, 2009
                                      11. Grossman JW et al: Comparison of the accuracy rates of 3-T and 1.5-T MRI of the knee in the diagnosis of meniscal tear. AJR Am J Roentgenol. 193(2):509-14, 2009
                                      12. Laundre BJ et al: MRI accuracy for tears of the posterior horn of the lateral meniscus in patients with acute anterior cruciate ligament injury and the clinical relevance of missed tears. AJR Am J Roentgenol. 193(2):515-23, 2009
                                      13. Stärke C et al: Meniscal repair. Arthroscopy. 25(9):1033-44, 2009
                                      14. De Smet AA et al: Clinical and MRI findings associated with false-positive knee MR diagnoses of medial meniscal tears. AJR Am J Roentgenol. 191(1):93-9, 2008
                                      15. De Smet AA et al: Clinical, MRI, and arthroscopic findings associated with failure to diagnose a lateral meniscal tear on knee MRI. AJR Am J Roentgenol. 190(1):22-6, 2008
                                      16. Mustonen AO et al: MRI of acute meniscal injury associated with tibial plateau fractures: prevalence, type, and location. AJR Am J Roentgenol. 191(4):1002-9, 2008
                                      17. Pujol N et al: Meniscal healing after meniscal repair: a CT arthrography assessment. Am J Sports Med. 36(8):1489-95, 2008
                                      18. Vinson EN et al: Association of peripheral vertical meniscal tears with anterior cruciate ligament tears. Skeletal Radiol. 37(7):645-51, 2008
                                      19. de Abreu MR et al: Meniscofemoral ligaments: patterns of tears and pseudotears of the menisci using cadaveric and clinical material. Skeletal Radiol. 36(8):729-35, 2007
                                      20. Boxheimer L et al: Characteristics of displaceable and nondisplaceable meniscal tears at kinematic MR imaging of the knee. Radiology. 238(1):221-31, 2006
                                      21. Majewski M et al: Midterm and long-term results after arthroscopic suture repair of isolated, longitudinal, vertical meniscal tears in stable knees. Am J Sports Med. 34(7):1072-6, 2006
                                      22. Terzidis IP et al: Meniscal tear characteristics in young athletes with a stable knee: arthroscopic evaluation. Am J Sports Med. 34(7):1170-5, 2006
                                      23. Tandogan RN et al: Analysis of meniscal and chondral lesions accompanying anterior cruciate ligament tears: relationship with age, time from injury, and level of sport. Knee Surg Sports Traumatol Arthrosc. 12(4):262-70, 2004
                                      24. Jee WH et al: Meniscal tear configurations: categorization with MR imaging. AJR Am J Roentgenol. 180(1):93-7, 2003
                                      25. Papachristou G et al: Isolated meniscal repair in the avascular area. Acta Orthop Belg. 69(4):341-5, 2003
                                      26. Binfield PM et al: Patterns of meniscal tears associated with anterior cruciate ligament lesions in athletes. Injury. 24(8):557-61, 1993
                                      27. Roeddecker K et al: Arthroscopic repair of traumatic longitudinal meniscal tears. A 3 to 5-year follow-up. Surg Endosc. 7(1):46-51, 1993
                                      28. Paletta GA Jr et al: Patterns of meniscal injury associated with acute anterior cruciate ligament injury in skiers. Am J Sports Med. 20(5):542-7, 1992
                                      29. Hanks GA et al: Repair of peripheral meniscal tears: open versus arthroscopic technique. Arthroscopy. 7(1):72-7, 1991
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Pathology

                                              • Clinical Issues

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Vertical longitudinal tear (VLT)
                                                • Synonyms

                                                  • Longitudinal tear
                                                • Definitions

                                                  • Tear along vertical long axis of meniscus
                                                  • Meniscal red zone: Peripheral 1/3 of meniscus; vascular zone
                                                  • Meniscal red-white junction: Middle 1/3 of meniscus
                                                  • Meniscal white zone: Central 1/3 of meniscus, near free edge
                                                  • Meniscectomy: Resection of portion or all (rarely) of torn meniscus

                                                IMAGING

                                                • General Features

                                                  • CT Findings

                                                    • MR Findings

                                                      • Imaging Recommendations

                                                        DIFFERENTIAL DIAGNOSIS

                                                          PATHOLOGY

                                                          • General Features

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Demographics

                                                                • Natural History & Prognosis

                                                                  • Treatment

                                                                    DIAGNOSTIC CHECKLIST

                                                                    • Consider

                                                                      • Image Interpretation Pearls

                                                                        • Reporting Tips

                                                                          Selected References

                                                                          1. Shelbourne KD et al: Evaluation of peripheral vertical nondegenerative medial meniscus tears treated with trephination alone at the time of anterior cruciate ligament reconstruction. Arthroscopy. 31(12):2411-6, 2015
                                                                          2. Kijowski R et al: MRI characteristics of healed and unhealed peripheral vertical meniscal tears. AJR Am J Roentgenol. 202(3):585-92, 2014
                                                                          3. Nguyen JC et al: MR imaging-based diagnosis and classification of meniscal tears. Radiographics. 34(4):981-99, 2014
                                                                          4. Davis KW et al: Magnetic resonance imaging and arthroscopic appearance of the menisci of the knee. Clin Sports Med. 32(3):449-75, 2013
                                                                          5. De Smet AA: How I diagnose meniscal tears on knee MRI. AJR Am J Roentgenol. 199(3):481-99, 2012
                                                                          6. Muriuki MG et al: Changes in tibiofemoral contact mechanics following radial split and vertical tears of the medial meniscus an in vitro investigation of the efficacy of arthroscopic repair. J Bone Joint Surg Am. 93(12):1089-95, 2011
                                                                          7. Alatakis S et al: MR imaging of meniscal and cartilage injuries of the knee. Magn Reson Imaging Clin N Am. 17(4):741-56, vii, 2009
                                                                          8. De Smet AA et al: MR diagnosis of posterior root tears of the lateral meniscus using arthroscopy as the reference standard. AJR Am J Roentgenol. 192(2):480-6, 2009
                                                                          9. DeHaan A et al: Evaluation of success of a meniscus repair device for vertical unstable medial meniscus tears in ACL-reconstructed knees. Orthopedics. 32(4), 2009
                                                                          10. Fetzer GB et al: Potential market for new meniscus repair strategies: evaluation of the MOON cohort. J Knee Surg. 22(3):180-6, 2009
                                                                          11. Grossman JW et al: Comparison of the accuracy rates of 3-T and 1.5-T MRI of the knee in the diagnosis of meniscal tear. AJR Am J Roentgenol. 193(2):509-14, 2009
                                                                          12. Laundre BJ et al: MRI accuracy for tears of the posterior horn of the lateral meniscus in patients with acute anterior cruciate ligament injury and the clinical relevance of missed tears. AJR Am J Roentgenol. 193(2):515-23, 2009
                                                                          13. Stärke C et al: Meniscal repair. Arthroscopy. 25(9):1033-44, 2009
                                                                          14. De Smet AA et al: Clinical and MRI findings associated with false-positive knee MR diagnoses of medial meniscal tears. AJR Am J Roentgenol. 191(1):93-9, 2008
                                                                          15. De Smet AA et al: Clinical, MRI, and arthroscopic findings associated with failure to diagnose a lateral meniscal tear on knee MRI. AJR Am J Roentgenol. 190(1):22-6, 2008
                                                                          16. Mustonen AO et al: MRI of acute meniscal injury associated with tibial plateau fractures: prevalence, type, and location. AJR Am J Roentgenol. 191(4):1002-9, 2008
                                                                          17. Pujol N et al: Meniscal healing after meniscal repair: a CT arthrography assessment. Am J Sports Med. 36(8):1489-95, 2008
                                                                          18. Vinson EN et al: Association of peripheral vertical meniscal tears with anterior cruciate ligament tears. Skeletal Radiol. 37(7):645-51, 2008
                                                                          19. de Abreu MR et al: Meniscofemoral ligaments: patterns of tears and pseudotears of the menisci using cadaveric and clinical material. Skeletal Radiol. 36(8):729-35, 2007
                                                                          20. Boxheimer L et al: Characteristics of displaceable and nondisplaceable meniscal tears at kinematic MR imaging of the knee. Radiology. 238(1):221-31, 2006
                                                                          21. Majewski M et al: Midterm and long-term results after arthroscopic suture repair of isolated, longitudinal, vertical meniscal tears in stable knees. Am J Sports Med. 34(7):1072-6, 2006
                                                                          22. Terzidis IP et al: Meniscal tear characteristics in young athletes with a stable knee: arthroscopic evaluation. Am J Sports Med. 34(7):1170-5, 2006
                                                                          23. Tandogan RN et al: Analysis of meniscal and chondral lesions accompanying anterior cruciate ligament tears: relationship with age, time from injury, and level of sport. Knee Surg Sports Traumatol Arthrosc. 12(4):262-70, 2004
                                                                          24. Jee WH et al: Meniscal tear configurations: categorization with MR imaging. AJR Am J Roentgenol. 180(1):93-7, 2003
                                                                          25. Papachristou G et al: Isolated meniscal repair in the avascular area. Acta Orthop Belg. 69(4):341-5, 2003
                                                                          26. Binfield PM et al: Patterns of meniscal tears associated with anterior cruciate ligament lesions in athletes. Injury. 24(8):557-61, 1993
                                                                          27. Roeddecker K et al: Arthroscopic repair of traumatic longitudinal meniscal tears. A 3 to 5-year follow-up. Surg Endosc. 7(1):46-51, 1993
                                                                          28. Paletta GA Jr et al: Patterns of meniscal injury associated with acute anterior cruciate ligament injury in skiers. Am J Sports Med. 20(5):542-7, 1992
                                                                          29. Hanks GA et al: Repair of peripheral meniscal tears: open versus arthroscopic technique. Arthroscopy. 7(1):72-7, 1991