Type 1 Ramp lesion is an isolated posterior superior meniscocapsular tear.
Meniscocapsular tears are located peripherally and involve the synovium, leading to posterior meniscocapsular separation from the posterior horn of the medial meniscus.
The meniscotibial ligament and the posterior horn itself remain intact.
This tear pattern is commonly located in the posteromedial “blind spot” and is particularly difficult to identify on arthroscopic exploration due to very limited mobility.
Sagittal image demonstrates peripheral vertical tear of the meniscocapsular ligament, as manifested by vertical linear high T2 (FSPD) signal reaching the superior articular surface.
Bone marrow edema within the posterior margin of the medial tibial plateau is also present, reflecting recent contrecoup injury.
In order to improve detection of ramp lesions, it is important to understand their varied appearances on MRI.
There are few classifications regarding meniscal ramp lesions.
Thaunat et al. approached a more comprehensive classification system which incorporates tear pattern, direction, tear thickness (partial versus full), and associated meniscocapsular junction, red-red zone, or meniscotibial ligament disruption and instability.
Greif et al. extended Taunat classification.
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