Completely filled in center or small void in center with thicker outer rim. However, the presence of a horizontal cleavage tear, especially in a child younger than 10 years, should raise the suspicion of a discoid meniscus. 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. Curr Opin Pediatr 2002; 14:54–61 [Google Scholar] 13. Snapping and pain are common … The natural history depends on the type of … the meniscus is discoid rather than semilunar in shape. Partial resection of the discoid 36. Etiopathogenesis is not known but congenital etiology is most likely. A discoid meniscus is a piece of cartilage shaped like a pancake or disc where a ring ought to be. The clinical presentation varies from being asymptomatic to snapping, locking, and causing severe pain and swelling of the knee. Discoid lateral meniscus in a young child: Case Joint Surg Br 1948;30:664-670. report and review of the literature. CONCLUSIONS: A redundant anterior segment associated with meniscal instability in the posterior segment is likely to cause limited knee extension in children with discoid lateral meniscus. Discoid meniscus lacks C-shaped configuration. Epidemiology. 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).. Healthy meniscus is shaped like crescent moons (in fact, “meniscus” comes from the Greek word for crescent). • Clin Orthop Surg Japan 1975;10:10-24. Long-term follow-up after excision. failure of apoptosis in utero. Discoid meniscus is a congenital variant of the knee joint that typically involves abnormal morphology and potential instability of the lateral meniscus. The normal configuration of a meniscus is that of a matured crescent moon, whereas that of a discoid meniscus generally is a thickened, very early crescent moon. The MD is usually asymptomatic. Definition. In a review by Dickason and associates, 23 the incidence of discoid medial meniscus was 0.12% and of discoid lateral meniscus was 1.5%. also referred to as "popping knee syndrome". The goal of surgery is to contour the discoid lateral meniscus to resemble a normal meniscus. The meniscus of the knee in an unborn child is disc shaped rather than moon shaped. They are found in the lateral side of the knee in approximately 5 percent of people of western European heritage … [] The surgical procedure performed was arthroscopic partial meniscectomy alone (22 knees), partial meniscectomy with repair (18 knees), or subtotal … discoid meniscus, MRI, child. Discoid menisci are a congenital meniscal variant commonly seen in the lateral compartment, with sporadic reporting of medial cases. The hypothesis was that partial meniscectomy left … Detailed history and physical examination combined with an MRI of the knee predictably diagnose a discoid meniscus. Apollo Hospitals, Chennai has performed a procedure that transformed a girl child’s life. Long-term follow-up after excision. The discoid (discoid: shaped liked or resembling a disk) meniscus, also called the popping knee syndrome, is a variation on the normal meniscus. Keywords Discoid lateral meniscus Children Magnetic resonance imaging (MRI) Arthroscopic resection Introduction Discoid meniscus is an often bilateral [26] anomaly with an incidence, which ranges between 1 and 17% [7, 9, 14], due to a high rate of asymptomatic patients. Menisci are fibrocartilaginous structures that are C-shaped (axial plane) and wedge-shaped (coronal plane). When this shape remains later in life, a discoid meniscus is present. A redundant anterior segment associated with meniscal instability in the posterior segment is likely to cause limited knee extension in children with discoid lateral meniscus. etiology. This pancake shape tends to lead to frequent meniscal tears. Discoid Meniscus (MD) is a rare meniscal abnormality. 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. incidence. The lateral meniscus is more commonly affected than the medial meniscus. Because of the pathologic anatomy and instability, discoid… location. Discoid lateral meniscus is an intra-articular knee disorder typically presented in the young population and during adolescence. In some cases the entire meniscus needs to be excised due to un-repairable damage to the meniscus. Discoid lateral menisci were first described in the late 1800s. Discoid menisci may be classified as complete, incomplete (partial) or Wrisberg type ( DeHaven and Bronstein, 1995 ). Symptomatic discoid menisci treated by arthroscopic surgery were examined preoperatively and postoperatively by magnetic resonance imaging (MRI). The discoid lateral-meniscus syndrome. • Shape deformation in discoid meniscus is an early sign of instability and may include surface changes, meniscal shift, and meniscal megahorn. The discoid meniscus is a common meniscal anomaly. Sometimes repairs (suturing/stitching) of meniscus is necessary to correct the meniscus, and this can only be assessed during surgery. Abnormal development of the meniscus leads to a hypertrophic and discoid shaped meniscus. Furthermore, most … There has been a trend toward choosing meniscal preservation procedures for treating discoid lateral meniscus. Discoid meniscus- presents as 'snapping knee syndrome' with pain and popping from lateral joint line- may be due to mechanical impingement of the thickened meniscus or a tear in the meniscus Popliteus tendinitis- diagnosis made clinically by tenderness over fibular collateral ligament with the knee in 'figure of 4' position Furthermore, most of the patients in those studies were adults. Aim of this study was to quantify the amount of meniscal resection when treating discoid meniscus in children by partial meniscectomy. Morphology of Discoid Lateral Meniscus in Pediatric Patients Anna Wood BS1, Jennifer Beck MD2 1David Geffen School of Medicine at UCLA, 2Orthopaedic Institute for Children and UCLA Department of OrthopaedicSurgery Our objective is to define the morphology of a discoid lateral meniscus in pediatric patients across different ages Anatomic variation alters normal mechanics and predisposes to tearing. ... who had had a total of eighteen meniscectomies performed for a discoid meniscus at The Hospital for Special Surgery between January 1, 1955, and December 31, 1983. Aichroth et al. Ahn et al evaluated the long-term clinical and radiographic results of arthroscopic reshaping, with or without peripheral meniscus repair, in 38 children (48 knees; mean age, 9.9 years) with symptomatic discoid lateral meniscus. 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. 14. Discoid lateral meniscus in children. The pathology mostly concerns the lateral meniscus and is presented in the young population and during adolescence. ‡ ‡ A discoid lateral meniscus can be asymptomatic throughout life or can present very early in childhood with the abovementioned symptoms. The condition was first reported by Young1 in 1889 when he dissected an anatom-ical specimen with a lateral discoid meniscus. 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. Discoid menisci are prone to tearing secondary to increased thickness, poor tissue quality, and instability. Different types of meniscal disorders and varied forms of presentation have been reported. present in 3-5% of population. J Pediatr Orthop 1998;8: 35. Singh K, Helms CA, Jacobs MT, Higgins L. MRI appearance of Wrisberg variant of discoid lateral meniscus. The children’s average age at operation was 10.5 years and the mean delay in diagnosis was 24 months. A discoid lateral meniscus is a meniscal abnormality first described by Young in 1889 60 and characterized as an enlarged and/or thickened meniscus with variable peripheral stability. Management of discoid lateral meniscus tears: observations in 34 knees. 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. Abstract Background Discoid lateral meniscus is the most frequent variant of the meniscus. Discoid meniscus. Kobajashi A, Uezaki N, Mitsuyasu M. Discoid meniscus of the 707-709. knee joint. Discoid lateral meniscus in children. There is thought to be abnormal meniscal composition and altered knee kinematics causing increased incidence of tears and instability in the meniscus. Discoid lateral meniscus in children. Introduction. Lateral Meniscal Variants: Evaluation and Treatment. 5 It is the most common abnormal meniscal variant in children. The most common symptoms of a discoid meniscus or torn discoid meniscus are: Pain Stiffness or swelling Catching, popping, locking of the knee Feeling that the knee is "giving way" Inability to fully extend (straighten) the knee 6 The condition is typically asymptomatic and, therefore, is infrequently diagnosed. Discoid lateral meniscus is a common abnormal meniscal variant in children. In addition to the existence of lateral discoid meniscus, … Magnetic reso-nance imaging (MRI) can be applied to diagnose a discoid reviewed 52 children with 62 discoid lateral menisci and an average follow-up of 5.5 years. Fujikawa K, Iseke F, Mikura Y. discoid meniscus is larger than usual. The discoid meniscus. 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. 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. Epidemiology. Although most discoid menisci involve the lateral menis-cus, the first cases of symptomatic discoid medial meniscus were re-ported by Watson-Jones2 in 1930 Davidson D, Letts M, Glasgow R. Discoid meniscus in children: treatment and outcome. Discoid lateral meniscus: prevalence of peripheral rim instability. Knee Discoid Lateral Meniscus. As DLM is a congenital anomaly, the ultrastructural features and morphology differ from those of the normal meniscus, potentially leading to meniscal tears. Some discoid menisci have abnormal peripheral attachments and are unstable. Description. This correlation mandates that discoid menisci be thoroughly evaluated during arthroscopic treatment to identify any instability that might require stabilization. All tear types can be seen with discoid meniscus. It is reported to be present bilateral in up to 20% of patients. AJR 2006; 187:384 –387 [Google Scholar] 14. Discoid lateral meniscus is the most frequent variant of the meniscus. Although it is usually located in the lateral side compartment, it may be more rarely medial. Dr. Vijay Kishore Reddy and team successfully completed a corrective procedure on a 7-year-old girl who was affected by discoid lateral meniscus tears, an abnormal condition in children.
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