Dr. Sereni returns to continue his discussion on meniscal injuries. In this podcast Dr. Sereni discusses the evolution of previously discussed basic tears into complex and displaced tears.Guest: Christopher Sereni, MD. Assistant Professor of Radiology, Division of Musculoskeletal Imaging & Intervention, UMMS Dept of Radiology.Host: Christopher Cerniglia, DO, ME, FAOCR. Associate Professor of Radiology, Division of Musculoskeletal Imaging & Intervention, UMMS Dept of Radiology.

Review•Abnormal signal or abnormal morphology•Three basic types of tears-Longitudinal vertical (aka the can-opener)-Horizontal (pita bread)-Radial (pizza slicer)-Complex tear - nonstandard combination of basic tear types

Tears in the setting of an ACL injury - a frequently overlooked setting•Mensicocapsular separation•Wrisberg rip -ACL tear allows tibia to translate anteriorly-Ligament of Wrisberg causes traction on posterior horn of the lateral meniscus, causing vertical longitudinal tear

Displaced tears •Longitudinal vertical --> bucket handle tear-central migration of inner portion with or without flipping-signs - not the be-all end-all -fragment in the notch-double anterior horn-double PCL-Small posterior horn/body•Horizontal tear --> flap tear-inferior flap tear could potentially go unnoticed on arthroscopy-boomerang sign-common displaced tear•Radial oblique tear --> Parrot beak tear-Displaced flap -Parrot beak appearance on axial sequence

Resources:• Saad SS, Gorbachova T, Saing M (2015) Meniscal tears: scanned, scoped, and sculpted. Radiographics 35(4):1138–1139• De Smet AA. How I diagnose meniscal tears on knee MRI. AJR Am J Roentgenol 2012;199(3):481–499.