Finally, look at the type 5 ramp lesion.
In this tear pattern, there are two separate tears within the red- red zone of the meniscus. So this is called a double tear.
Type 5 ramp lesions are similar to type 4a.
The subtype 4A is a complete longitudinal vertical tear of the red-red zone of the meniscus, with the meniscocapsular and meniscotibial ligaments intact but connected to a portion of the posterior horn junction via a free-floating fragment of the meniscus, thus leading to instability of both structures
Type 4A ramp lesion has only one complete longitudinal vertical tear, but type 5 ramp lesion has two parallel tears.
Similar to the 4A subtype, the meniscocapsular and meniscotibial ligaments are intact.
This patient has chronic ACL injury.
Two parallel linear high T2 fluid intensity signal areas extending from the superior to the inferior articular surface within the red-red zone of the posterior horn.
Outer longitudinal tear is here, inner longitudinal tear is here.
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