Discoid meniscus is a rare human anatomic variant that usually affects the lateral meniscus of the knee. Discoid meniscus is an abnormal meniscus that is thicker than normal and has a different shape and texture that usually affects the lateral meniscus of the knee 1).. There are two menisci in the knee joint, with one on the outside (away from midline) being the lateral meniscus and the inner one (towards midline) the medial meniscus. Some patients may experience the feeling that their knee is giving away. Coronal and radial images of the meniscus are useful to demonstrate the extension of the aberrant meniscus into the joint as seen here. Sports Medicine physical therapy will get you back in the game! Long-term follow-up after excision. Fig 5. To diagnose discoid lateral meniscus, the height of the lateral tibial spine, lateral joint space distance, height of the fibular head, and obliquity of the lateral tibial plateau were measured, according to Choi’s method (Fig. THE DISCOID LATERAL MENISCUS (DLM) is an ana-tomic variant of the meniscus, in which the meniscus is thickened and discoid shaped, and the DLM covers a greater area of the tibial plateau than the normal meniscus. In most instances, the meniscus is very thin and degenerative when it does tear and a good portion of it needs to be resected. It is reported to be present bilateral in up to 20% of patients. Our Pediatric Sports Medicine team put together these videos to provide information for you. As DLM is a congenital anomaly, the ultrastructural features and morphology differ from those of the normal meniscus, potentially leading to meniscal tears. “In cases where there is significant disability, surgical excision may be needed. The pathology mostly concerns the lateral meniscus and is presented in the young population and during adolescence. Generally, congenital anomalies affect the lateral meniscus, most commonly a discoid meniscus, although discoid medial menisci can occur much less frequently. Discoid medial meniscus can occur as well but is rare in my experience.… 7 The most frequent symptom is pain that usually begins with a minor trauma. Discoid lateral meniscus in children. Please help. Neuschwander DC, Dres D, Finney TP:"Lateral meniscal variant with absence of the posterior coronary ligament". Although the histology of normal menisci in children and in adults has been well described, few studies have focused on the histology of discoid menisci. As DLM is a congenital anomaly, the ultrastructural features and morphology differ from those of the normal meniscus, potentially leading to meniscal tears. Discover the future of children’s healthcare. Abnormal development of the meniscus leads to a hypertrophic and discoid shaped meniscus. People may be born with this. If a discoid meniscus is not causing pain, popping, or other symptoms, then treatment may not be necessary. The clinical presentation varies from being asymptomatic to snapping, locking, and causing severe pain and swelling of the knee. Management of discoid lateral meniscus tears: observations in 34 knees. At Sports Medicine, we will develop a treatment plan for your discoid meniscus. The purpose of this study was to evaluate the clinical characteristics and intra-articular variants of SDLM in a Chinese population. I was thinking 29881, but am not sure. Detailed history and physical examination combined with an MRI of the knee predictably diagnose a discoid meniscus. Arthroscopic view of an unstable discoid lateral meniscus with a radial tear in a left knee, viewing through an anterolateral portal. It typically affects the lateral meniscus and may be found bilaterally in 20% of cases. Sometimes repairs (suturing/stitching) of meniscus is necessary to correct the meniscus, and this can only be assessed during surgery. When a discoid meniscus causes symptoms, arthroscopic surgery is often necessary. X-rays and an MRI may be used to confirm the diagnosis and show whether there are other problems in the knee. In addition, a discoid meniscus does not taper as much towards the center of the joint and is shaped like a disc. 2 It results when the lateral meniscus does not differentiate into a semilunar shape and instead forms a thick wafer of fibrocartilaginous tissue. 501 6th Avenue South St. Petersburg, FL 33701, Clinical and Translational Research Organization, Center for Medical Simulation and Innovative Education, Institute for Fundamental Biomedical Research. 5 It is the most common abnormal meniscal variant in children. There are 3 types: Incomplete: The meniscus is slightly thicker and wider than normal. Discoid lateral meniscus (DLM) is a common anatomic variant in the knee typically presented in young populations, with a greater incidence in the Asian population than in other populations. A discoid meniscus should be considered if more than two contiguous body segments are present. Journal of Bone and Joint Surgery American, 1992;74: 1186-1190. Discoid meniscus is a rare human anatomic variant that usually affects the lateral meniscus of the knee. Discoid lateral meniscus (DLM) is relatively common in East Asia..Symptomatic discoid lateral meniscus (SDLM) is an important indication for knee arthroscopic surgery. The goal of surgery is to contour the discoid lateral meniscus to resemble a normal meniscus. Since it is difficult to diagnose meniscal anomalies with X-ray, an MRI would be necessary to visualize the discoid meniscus. 0. failure of apoptosis in utero. The discoid (discoid: shaped liked or resembling a disk) meniscus, also called the popping knee syndrome, is a variation on the normal meniscus. Ozcanli H, Keles N, Gocmen-Mas N, Ozenci AM, Aydin AT Surg Radiol Anat 2011 Oct;33(8):673-8. The meniscus cartilage, which is the critical shock absorber in the knee, is sometimes deformed at birth and causes problems later in life. The discoid lateral-meniscus syndrome. See our events for patients, families, health professionals and our community. A probe (arrow) is being used to pull the posterior horn anteriorly. Healthy meniscus is shaped like crescent moons (in fact, “meniscus” comes from the Greek word for crescent). 6 The condition is typically asymptomatic and, therefore, is infrequently diagnosed. However, studies investigating SDLM are rare. However, this method may lead to a false negative when evaluating people with the Wrisberg variant of discoid meniscus since it maintains a narrow crescent shape. Once a discoid meniscus is torn, it usually does not heal because the meniscus lacks a … A discoid meniscus causes pain, stiffness, and swelling of the knee. Feb 3, 2011. Physical therapy at Johns Hopkins All Children’s is provided in an atmosphere developed for teen athletes with a one to one ratio for the highest quality of care needed for maximum outcomes and return to play. The thick, abnormal shape of a discoid meniscus makes it more likely to tear or get stuck in the knee. At Sports Medicine, we will examine your knee with specific tests to help assess for a discoid meniscus. 6 The condition is typically asymptomatic and, therefore, is infrequently diagnosed. Discoid lateral meniscus: prevalence of peripheral rim instability. To request an appointment or to get more information, call: Get our symptom checker app for iphone or android. A discoid meniscus is an abnormally shaped meniscus in the knee. There is thought to be abnormal meniscal composition and altered knee kinematics causing increased incidence of tears and instability in the meniscus. Most people, however, will have knee problems related to the discoid meniscus. Once a discoid meniscus is torn, it usually does not heal because the meniscus lacks a strong blood supply. The clinical presentation varies from being asymptomatic to snapping, locking, and causing severe pain and swelling of the knee. Español | العربية | Tiếng Việt | 日本語 | Kreyòl Ayisyen | Français | Русский | Português | हिंदी | Kiswahili. In some cases the entire meniscus needs to be excised due to UN repairable damage to the meniscus. Epidemiology. There are actually two menisci in your knee, one is on the inner (medial) side of the knee and the other is on the outer (lateral) side of the knee. Ikeuchi 14 analyzed 49 stable discoid lateral menisci and concluded that arthroscopic treatment of the torn discoid meniscus is difficult and that total, rather than partial, meniscectomy is more likely to be successful. present in 3-5% of population. Fig 4. Lateral Meniscal Variants: Evaluation and Treatment. The disoid meniscus was further saucerized to a normal configuration and the anterolateral torn portion excised. The menisci are attached to the femur bone by a strong tissue called the meniscofemoral ligament. Healthy meniscus is shaped like crescent moons (in fact, “meniscus” comes from the Greek word for crescent). Knee Discoid Lateral Meniscus. It typically affects the lateral meniscus and may be found bilaterally (20%). The meniscus is a type of cartilage cushion in the knee that protects the true joint cartilage from injury as the thigh bone moves over the top of the leg bone. Arthroscopic view of the discoid lateral meniscus after saucerization in a left knee, viewing through an anterolateral portal. 77.8). The discoid lateral-meniscus syndrome. location. A normal lateral meniscus is crescent moon-shaped while a discoid lateral meniscus looks like a disc ie round. incidence. Instead of being C-shaped, the central part of the meniscus is filled in with tissue. Discoid meniscus. And when the knee is bent or stretched it makes the sound of bouncing bones. The orthopedic classification of discoid menisci includes: complete, incomplete or Wrisberg-ligament types as depicted here. Coverage of the lateral tibial plateau determines the designation of complete or incomplete. Arthroscopic view of the discoid lateral meniscus after saucerization in a left knee, viewing through an anterolateral portal. Lateral discoid meniscus is far more common than medial discoid meniscus, with the latter being rare. Epidemiology. The lateral meniscus of a right knee is shown below in green. Long-term follow-up after excision. Discoid menisci are a congenital meniscal variant commonly seen in the lateral compartment, with sporadic reporting of medial cases. Wrisberg ligament type- the lateral meniscus has no attachment to the tibial plateau posteriorly but has a menisco femoral ligament or ligament of Wrisberg Discoid lateral meniscus is a congenital condition that is estimated to occur in 4% to 5% of the population 1-4 but has been shown to be as high as 13% in Asian populations. discoid meniscus is larger than usual. Symptoms often begin during childhood and injuries to the discoid meniscus usually occur with twisting motions to the knee. The discoid lateral meniscus (DLM) of the knee is an abnormally wide and thick meniscus that completely or incompletely covers the articular surface of the lateral tibial plateau. :"Primer of Diagnostic Imaging", Mosby editions, 2003, http://www.orthoseek.com/articles/discoid.html, https://en.wikipedia.org/w/index.php?title=Discoid_meniscus&oldid=1021888264, Creative Commons Attribution-ShareAlike License, This page was last edited on 7 May 2021, at 06:56. At birth the entire meniscus has a blood supply at birth but by 10 years of age the central third has become avascular. Arthroscopic view of the discoid lateral meniscus after saucerization in a left knee, viewing through an anterolateral portal. In many cases, the most effective treatment is to remove the part of the discoid meniscus that is torn and then reshape and preserve the remaining meniscus. Surgical treatment for sports injuries at Johns Hopkins All Children’s is provided by the surgeons at COSSA. When the discoid meniscus is severely damaged, total excision of the meniscus may be necessary. What Is Discoid Lateral Meniscus Tear? Discoid lateral meniscus is a congenital condition that is estimated to occur in 4% to 5% of the population 1-4 but has been shown to be as high as 13% in Asian populations. Complete: The meniscus completely covers the tibia. Relation of discoid lateral meniscus and cord-like anterior intermeniscal ligament: morphological and clinical study. How is a discoid meniscus injured? Need surgery? [3] Rarely, X-ray may show lateral joint space widening, squaring of the lateral condyle, cupping of the lateral tibial plateau and hypoplasia of the lateral tibial spine that suggest discoid meniscus. Strong suggestive findings on magnetic resonance imaging includes a thickened meniscal body seen on more than two contiguous sagittal slices. Most people complain of catching, popping, and locking of the knee. When a discoid meniscus, most commonly involving the lateral meniscus, tears, it is necessary to perform treatment on it due to symptoms from the tear. Discoid lateral meniscus is the most frequent variant of the meniscus. The meniscus is a wedge-shaped piece of cartilage located between the bones of the knee and acts as a cushion to protect the bones during movement .There are two menisci in the knee, the medial meniscus on the inside of the knee, and the lateral meniscus on the outside. Most people complain of catching, popping, and locking of the knee. Instead of the narrow crescent shape, as seen in a normal meniscus above, a discoid meniscus is thickened, and has a fuller crescent shape. The Watanabe classification of discoid lateral meniscus is: (A) Incomplete, (B) Complete, and C) Wrisberg-ligament variant [2] Normally, the meniscus is a thin crescent-shaped piece of cartilage that lies between the weight bearing joint surfaces of the femur and the tibia. Discoid meniscus is an abnormal meniscus that is thicker than normal and has a different shape and texture that usually affects the lateral meniscus of the knee 1). DISCOID LATERAL MENISCUS Defnition Discoid lateral meniscus (DLM) is an anatomic variation of the lateral meniscus that may be asymptomatic or can cause snapping or popping of the knee. Furthermore, most of the patients in those studies were adults. A discoid meniscus was said to be present if three or more 5-mm-thick contiguous sagittal images demonstrated continuity of the meniscus between the anterior and posterior horns. High-resolution coronal images allowed more graphic depiction of the abnormally wide meniscus. Discoid lateral meniscus in children. Weissleder, et al. Fig 6. 5 It is the most common abnormal meniscal variant in children. Most patients will return to normal daily activities only a few weeks after arthroscopy for a discoid meniscus. Smartphone App Discoid lateral meniscus is a common abnormal meniscal variant in children. A discoid meniscus is an abnormally shaped meniscus in the knee. Three types of DLM 1. This ligament also provides a blood supply to a small portion of the meniscus. There are 3 types: Incomplete: The meniscus is slightly thicker and wider than normal. Lateral meniscus had a discoid appearance with some tearing of the anterolateral aspect. [1] Usually a person with this anomaly has no complaints; however, it may present as pain, swelling, or a snapping sound heard from the affected knee. It is commonly found in the lateral meniscus. Fig 4. Management of discoid lateral meniscus tears: observations in 34 knees. Call 727-898-2663. If your child has knee pain and you’re concerned he or she may have a discoid meniscus, call 727-76SPORT to schedule an appointment with our Sports Medicine physicians, who will determine a diagnosis and recommend further treatment.. Discoid Meniscus Injury. Clinical presentation may, therefore, be either incidental or with pain, locking or a 'clunk'. Language Assistance Available: Therefore, within physical therapy we also assess and work to correct biomechanics; proper techniques for lifting, squatting, running, throwing and so on. A discoid lateral meniscus is a common normal variant, occurring in approximately 3-5% of the population. A discoid meniscus is an abnormally shaped piece of cartilage that acts as a shock absorber in the knee between the thighbone (femur) and shinbone (tibia). Discoid meniscus most often affects the lateral meniscus, which is the on the outside of the knee joint. Discoid lateral meniscus is a common abnormal meniscal variant in children. A discoid meniscus is a congenital anomaly of the knee found in 3% of the population (Fig. Best answers. Discoid lateral meniscus is a variant of a normal meniscus. Discoid lateral meniscus: prevalence of peripheral rim instability. In a patient complaining of acute onset knee pain, an X-ray study would be done to rule out any bony pathology such as a fracture. Usually a person with this anomaly has no complaints; however, it may present as pain, swelling, or a snapping sound heard from the affected knee. A subgroup of the discoid lateral meniscus known as the Wrisberg variant occurs when there is no posterior attachment of the lateral meniscus. Discoid lateral meniscus is the most frequent variant of the meniscus and it is bilateral in up to 20% of cases (Yaniv & Blumberg, 2007). Because of its abnormal shape, it is more prone to injury than a normally shaped meniscus. What is Jumper's Knee (Patellar tendonitis). Symptom is usually pain in the knee. When a discoid meniscus, most commonly involving the lateral meniscus, The transverse diameter of a normal meniscus is approximately 10 to 11 mm; therefore a normal meniscus body will be visible on only 2 slices of a MR with 4-5-mm sagittal slices. A discoid meniscus causes pain, stiffness, and swelling of the knee. Complete: The meniscus completely covers the tibia. It was first described by Young in 1889 [ 1 ]. Discoid lateral meniscus (DLM) is a common anatomic variant in the knee typically presented in young populations, with a greater incidence in the Asian population than in other populations. Clinical presentation. #1. I have not had this one before. A discoid meniscus is an abnormally shaped piece of cartilage that acts as a shock absorber in the knee between the thighbone (femur) and shinbone (tibia). In the Community The problems associated with this condition, called discoid meniscus, can be significant. To find a pediatrician or pediatric specialist, please search our directory. 3 b) (Table 1). Arthroscopic view of an unstable discoid lateral meniscus with a radial tear in a left knee, viewing through an anterolateral portal. The thickness of the meniscus, its diminished vascular blood supply, and in some instances, weak capsular attachment, makes it more prone to tears compared to a normal meniscus. Fig 5. Pathology Although frequently asymptomatic, discoid menisci are prone to cystic degeneration with subsequent tear. Although the histology of normal menisci in children and in adults has been well described (Clark & Ogden, 1983), few studies have focused on the histology of … also referred to as "popping knee syndrome". A discoid meniscus generally covers the entire tibial plateau. Depending on the patient’s prior activity level and needs for returning to sport, we also progress their exercises and give them the knowledge to continue strengthening after discharge from physical therapy by providing a thorough home exercise program, customized to each patient. Discoid lateral menisci were first described in the late 1800s. It is attached to the lining of the knee joint along its periphery and serves to absorb about a third of the impact load that the joint cartilage surface sees and also provides some degree of stabilization for the knee. A discoid meniscus is a congenital anomaly of the knee found in 3% of the population (up to 15% in Asia). Get our symptom checker app for iphone or android. The anomaly in itself is asymptomatic; however, a tear of the meniscus can result in pain, swelling, and snapping in the affected knee. Discover the future of children’s healthcare. During arthroscopy, the surgeon inserts a small camera in the knee and uses these images to guide miniature surgical instruments. Dr. Ebraheim’s educational animated video describes Discoid meniscus. Some patients may experience the feeling that their knee is giving away. If the patient is asymptomatic and does not complain of significant locking sensation in the knee or pain, treatment is conservative and consists of stretching and strengthening exercises for the quadriceps and hamstring muscles. In most cases where the meniscus is still generally intact, a partial excision to preserve the cushioning function may be sufficient.”[4]. On coronal images, it is diagnosed when the horizontal measurement between the free margin and the periphery of the body is more than 1.4 cm. Because of its abnormal shape, it is more prone to injury than a normally shaped meniscus. The Wrisberg-ligament type has an abnormal posterior attachment by attaching to part of the posterior cruciate ligament. If your child has been diagnosed with discoid meniscus and you would like to schedule a consultation with one of our orthopaedic surgeons, call Children’s Orthopaedic and Scoliosis Surgery Associates (COSSA), L.L.P., at 727-898-2663. etiology. Our goal at Sports Medicine is to get our patient back to participating in their favorite activities, including sports. The thick, abnormal shape of a discoid meniscus makes it more likely to tear or get stuck in the knee. Some people with discoid meniscus may go through their entire lives and never experience any problems. Fig 6. A probe (arrow) is being used to pull the posterior horn anteriorly. Lateral Meniscal Variants: Evaluation and Treatment. Strong suggestive findings on magnetic resonance imaging includes a thickened meniscal body seen on more than two contiguous sagittal slices. Discoid menisci are congenital, frequently bilateral (up to 50%) and have been reported in twins, although no genetic locus has been identified 2.There is a higher prevalence in Asians without any gender predilection 7.. Lateral discoid meniscus is far more common than medial discoid meniscus, with the latter being rare. We then perform a standard inside-out meniscal repair by incising our previously marked incision parallel and just posterior to the lateral collateral ligament with the knee in … In many cases, however, children who have never experienced a major injury can also have locking and popping in the knee from the discoid meniscus. We will review the common meniscal variants, which include hypoplastic menisci, absent menisci, anomalous insertion of the medial meniscus, discoid lateral meniscus, including the Wrisberg variant, and discoid medial meniscus. Detailed history and physical examination combined with an MRI of the knee predictably diagnose a discoid meniscus.

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