This 12-year-old female presents with left knee pain, and the clinician alleges meniscal tear. The initial read was noncommunicating tear, but is this the proper call? You are shown four gradient echo sagittal water-weighted images and one sagittal T1.
Sagittal
Sagittal
Sagittal
Sagittal
Sagittal T1
No, this was not the proper call! Save the whales and the menisci. It’s a 12-year-old. High signal due to vascularity and overuse is not uncommon in this age group. A meniscectomy in a 12-year-old is a DISASTER in most cases in the long term. This signal fades in meniscus inner third and is most conspicuous in the outer one-third red-red zone. It is also window framed by dark signal, the meniscus has normal size and shape, the signal in the meniscus is ill-defined and not very bright on T1 and finally T2* gradient echoes always tend to overestimate signal in menisci compared to proton density SPIR MRI. Patient has patellofemoral maltracking as cause of pain anyway. There is NO meniscal tear.
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