Abstract
Objective
Bucket-handle tear is a displaced vertical longitudinal tear of the meniscus. Several signs of the tear have been described on MRI but none in the axial plane. We propose to describe such a sign named the V-sign that is seen at the junction of the displaced fragment and the meniscus, which is in place.
Materials and methods
MRI imaging of 25 surgically proven bucket-handle tears was reviewed for presence of the V-sign. Two control groups, one with normal menisci (n = 75) and one with surgically proven non-bucket-handle tears (n = 25), were also evaluated. Comparisons for presence or absence of the V-sign were performed among the three groups, and also for other commonly associated signs such as double PCL sign, double delta sign, and presence of ACL tear. Also, sensitivity, specificity, and positive and negative predictive values were calculated.
Results
Among those with bucket-handle tear, 72% demonstrated the V-sign while no participant in either control group had the V-sign (P ≤ 0.001). The V-sign occurred in 38% of those with double PCL sign, 55.6% with ACL tear, and 66.7% with double delta sign. The V-sign had higher sensitivity and negative predictive values than other signs related to bucket-handle tear.
Conclusion
The V-sign, when seen on an axial plane image, is highly suggestive of bucket-handle tear. Our data suggest the benefit of using the V-sign for detecting bucket-handle tears, perhaps even above other commonly used approaches.
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References
Chapin RW, Reeves BE, Pope TL. Bucket-handle tear of the medial meniscus accompanying an ACL rupture. Appl Radiol. 2005;34(8):35–7.
Wright DH, De Smet AA, Norris M. Bucket-handle tears of the medial and lateral menisci of the knee: value of MR imaging in detecting displaced fragments. AJR. 1995;165:621–5.
Ruff C, Weingardt JP, Russ PD, Kilcoyne RF. MR imaging patterns of displaced meniscus injuries of the knee. AJR Am J Roentgenol. 1998;170:63–7.
Singson RD, Feldman F, Staron R, Kiernan H. MR imaging of displaced bucket-handle tear of the medial meniscus. AJR Am J Roentgenol. 1991;156:121–4.
Weiss KL, Morehouse HT, Levy IM. Sagittal MR images of the knee: a low-signal band parallel to the posterior cruciate ligament caused by a displaced bucket-handle tear. AJR Am J Roentgenol. 1991;156:117–20.
Watt AJ, Halliday T, Raby N. The value of the absent bow tie sign in MRI of bucket-handle tears. Clin Radiol. 2000;55:622–6.
Helms CA, Laorr A, Cannon Jr WD. The absent bow tie sign in bucket-handle tears of the menisci in the knee. AJR Am J Roentgenol. 1998;170:57–61.
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Rao, N., Patel, Y., Opsha, O. et al. Use of the V-sign in the diagnosis of bucket-handle meniscal tear of the knee. Skeletal Radiol 41, 293–297 (2012). https://doi.org/10.1007/s00256-011-1181-8
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DOI: https://doi.org/10.1007/s00256-011-1181-8