Doctors Aren't Fooled by Symptoms of Meniscal TearInjury to cartilage in the knee, called the meniscus, is the most common reason for knee surgery. The meniscus on the inside edge of the joint is the medial meniscus. Medial meniscus tears can cause painful popping and swelling. The knee joint can get stuck or locked in one position.
Sometimes what looks like a medial meniscus tear turns out to be something else that doesn't need surgery. This is a report of three such cases. All three patients had a history and symptoms just like the doctor would see with a medial meniscus injury. The three patients injured their knees in various ways. One 24-year-old postal service worker fell from a curb, twisting his left knee. A 24-year-old rugby player twisted his right knee during a game, and a 19-year-old hurt himself without knowing it while surfing. In each case the doctor used an arthroscope to look inside the joint. This device has a tiny TV camera on the end and helps make an accurate diagnosis.
The arthroscope showed that none of the three patients had a medial meniscus tear. The medial meniscus was just fine. Instead, all had a torn coronary ligament. The coronary ligament fits around each meniscus like an apron. It loosely holds the meniscus to the lower leg bone just below the meniscus. When torn or ruptured, this ligament heals by itself over a few months. Surgery isn't needed unless something else is also damaged.
The authors point out that these cases show how damage to the coronary ligament in the knee can mimic a torn medial meniscus. It's important to get the correct diagnosis to avoid unnecessary surgery.
Laura Lougher, MRCS, et al. Coronary Ligament Rupture as a Cause of Medial Knee Pain. In The Journal of Arthroscopy. December 2003. Vol. 19. No. 10. Pp. 19-20.
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