There are two different subtypes of type 3 lesions in order to account for the meniscotibial ligament instability.
Type 3A represents a vertical peripheral tear of the inferior margin of the posterior horn containing the attachment of the meniscotibial ligament.
The other subtype (type 3B) is a tear of the meniscotibial ligament itself from its attachment to the posterior horn.
This includes rupture in the midsubstance of the ligament or an avulsion of the ligament from the meniscal insertion.
Here is peripheral partial vertical tear affecting the inferior surface of the posterior horn of medial meniscus, and tear along with meniscotibial ligament as well.
As compared with normal finding of posteromedial knee, we can see that there is a meniscotibial ligament tear.
Subtype 3B accounts for the meniscotibial ligament being torn from its attachment to the posterior horn without further meniscal injury.
On MRI this manifests as disruption of the ligament with high T2 signal and often concomitant bone marrow edema pattern within the posterior margin of the medial tibial plateau from recent contrecoup injury
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