(Fig 2-B.31) Ramp lesion versus no ramp lesion in ACL injury

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1️⃣ Meniscal Ramp Lesion

• Ramp lesions refer to injuries affecting the posterior horn of the medial meniscus in the setting of ACL tears.

• A high signal at the meniscocapsular junction without a frank fluid cleft indicates a sprain rather than a true separation.

2️⃣ False Positive Ramp Lesions

• Edema affecting the posterior capsule reflects pericapsular soft tissue damage; however, edema alone is insufficient for diagnosing a ramp lesion.
• Skeletal Radiology (2018) 47:1683–1689

3️⃣ Diagnostic Challenges and Criteria

 

• No single MRI criterion achieves 100% sensitivity or specificity for diagnosing meniscal ramp lesions.
• The junctional fluid-like signal was found to be highly specific for meniscal ramp lesions, boasting a PPV (Positive Predictive Value) of 92.9%.
• AJR American Journal of Roentgenology, March 2021; 216(3):791-798.

 

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