Case 3 - “Wipe Away the Tear”
By Dean Thornton
After successfully completing a big marathon, a 40-something female runner finally admits to herself and to her running coach that her left knee has been hurting for awhile now. Her knee also feels “puffy” and “swollen”. Backing off of training for a few weeks does little to help the pain, so off to the sports medicine physician she goes. After a thorough physical examination of the knee, the physician has a pretty good idea of what is going on. But to confirm his diagnosis, he sends the patient for an MRI.
The first MR image, a coronal (or front) view, clearly shows the abnormality. There is a bright line (small arrows) through the middle of the black triangle which is the medial meniscus. This bright line represents a tear in the meniscus filled with inflammation and joint fluid. Contrast the appearance of the torn medial meniscus with the normal lateral meniscus (curved arrow) which retains it sharp, black, triangular shape. The second MR image, a sagittal (or side) view, again shows the tear in the medial meniscus (arrows). A moderate amount of bright fluid (joint effusion) is present in the front and back of the knee as indicated by the “X” symbols.
DIAGNOSIS: Medial meniscal tear.
The menisci are made of a type of elastic cartilage (fibrocartilage). The menisci have two primary functions: joint stability and shock absorption. They help cushion the forces that are transmitted across the knee from the femur to the tibia with every step. Sometimes, an extreme force or an awkward twist can result in an acute tear of the meniscus. But often, as in the case of our marathoner, years of walking or running can cause a degenerative tear of the meniscus to develop.
Fortunately, many meniscal tears can be treated with arthroscopic surgery (which is less invasive and requires less recovery time). Our high-achieving marathoner was back running the streets within weeks of her surgery (following the instructions of her physician and physical therapist, of course).
For more information about meniscal tears, visit: Meniscal Injuries
Dean Thornton, MD
Dean is a Musculoskeletal Radiologist with Radiology Associates of Birmingham and a Clinical Associate Professor of Radiology at UAB. He works with many local orthopedists and sports medicine physicians. He also likes to run.
Inside the Runner uses medical imaging to offer readers a chance to see what is going on inside their bodies when something breaks down. From fractures to tendonitis to muscle injuries, this series explores the imaging studies used to help doctors and other medical professionals treat running injuries.
Inside the Runner uses medical imaging to offer readers a chance to see what is going on inside their bodies when something breaks down. From fractures to tendonitis to muscle injuries, this series explores the imaging studies used to help doctors and other medical professionals treat running injuries.