MRI evaluation of hypermobile lateral meniscus beyond distance measurements: the role of integrated popliteomeniscal fascicle assessment.
- 1Department of Orthopedic Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea.
- 2Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea.
- 3Department of Orthopedic Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea. [email protected].
Abstract
Background
Hypermobile lateral meniscus (HLM) causes lateral knee pain and mechanical symptoms, but preoperative identification remains challenging because HLM is a dynamic abnormality that is not always captured on static magnetic resonance imaging (MRI). Previous MRI-based studies have mainly focused on linear measurements or qualitative popliteomeniscal fascicle (PMF) abnormalities. This study aimed to evaluate whether spatial MRI assessment beyond conventional linear distance measurements could help characterize arthroscopically confirmed HLM. We also aimed to determine whether MRI-derived markers could be organized into a clinically interpretable MRI-based approach to raise preoperative suspicion for HLM.Methods
This retrospective study included patients who underwent knee MRI followed by arthroscopic assessment of lateral meniscal stability. After propensity score matching, 53 knees with arthroscopically confirmed HLM and 53 non-HLM surgical controls were analyzed. MRI-derived variables included LM-popliteal tendon distance, region-of-interest-based measurement, MRI signal intensity ratio, and PMF integrity. Each PMF was evaluated separately and then summed to obtain the combined PMF score. Firth's logistic regression, receiver operating characteristic curve, and Youden index analysis were performed.Results
Static measurements of LM-popliteal tendon separation did not differ between groups. In contrast, the sagittal MRI signal intensity ratio (odds ratio [OR], 1.067; 95% confidence interval [CI] 1.012-1.137; p = 0.044) and the combined PMF score were significantly associated with HLM (OR, 0.098; 95% CI 0.034-0.257; p < 0.001) were significantly associated with HLM in univariable analysis. In multivariable analysis, only the combined PMF score remained independently associated with HLM. The PMF score-only model showed an area under the curve of 0.794 (95% CI 0.709-0.879), with a Youden-derived threshold of ≤ 1.0, sensitivity of 58.5%, specificity of 86.8%, and accuracy of 72.6%.Conclusions
The combined PMF score was the MRI-derived marker most consistently associated with arthroscopically confirmed HLM. In this selected surgical cohort, lower combined PMF scores showed acceptable discrimination and relatively high specificity, although sensitivity was modest. Accordingly, a combined PMF score of ≤ 1.0 may provide adjunctive MRI information that raises suspicion for HLM when the clinical presentation is suggestive, but it cannot exclude HLM or independently establish the diagnosis, and the decision to perform arthroscopy should not be based on the score alone. Arthroscopic dynamic assessment remains necessary for definitive confirmation.
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BibTeX
@article{park2026evaluation,
title = {{MRI evaluation of hypermobile lateral meniscus beyond distance measurements: the role of integrated popliteomeniscal fascicle assessment.}},
author = {Hyung Jun Park and Jung Hyun Park and Euddeum Shim and Se Rang Moon and Dong Hun Suh and Jae Gyoon Kim},
journal = {Knee surgery \& related research},
year = {2026},
month = oct,
doi = {10.1186/s43019-026-00354-0},
url = {https://europepmc.org/article/MED/42920202},
note = {CC BY},
}
RIS
TY - JOUR
TI - MRI evaluation of hypermobile lateral meniscus beyond distance measurements: the role of integrated popliteomeniscal fascicle assessment.
AU - Hyung Jun Park
AU - Jung Hyun Park
AU - Euddeum Shim
AU - Se Rang Moon
AU - Dong Hun Suh
AU - Jae Gyoon Kim
PY - 2026
DA - 2026/10/23
JO - Knee surgery & related research
DO - 10.1186/s43019-026-00354-0
UR - https://europepmc.org/article/MED/42920202
AB - Background Hypermobile lateral meniscus (HLM) causes lateral knee pain and mechanical symptoms, but preoperative identification remains challenging because HLM is a dynamic abnormality that is not always captured on static magnetic resonance imaging (MRI). Previous MRI-based studies have mainly focused on linear measurements or qualitative popliteomeniscal fascicle (PMF) abnormalities. This study aimed to evaluate whether spatial MRI assessment beyond conventional linear distance measurements could help characterize arthroscopically confirmed HLM. We also aimed to determine whether MRI-derived markers could be organized into a clinically interpretable MRI-based approach to raise preoperative suspicion for HLM.Methods This retrospective study included patients who underwent knee MRI followed by arthroscopic assessment of lateral meniscal stability. After propensity score matching, 53 knees with arthroscopically confirmed HLM and 53 non-HLM surgical controls were analyzed. MRI-derived variables included LM-popliteal tendon distance, region-of-interest-based measurement, MRI signal intensity ratio, and PMF integrity. Each PMF was evaluated separately and then summed to obtain the combined PMF score. Firth's logistic regression, receiver operating characteristic curve, and Youden index analysis were performed.Results Static measurements of LM-popliteal tendon separation did not differ between groups. In contrast, the sagittal MRI signal intensity ratio (odds ratio [OR], 1.067; 95% confidence interval [CI] 1.012-1.137; p = 0.044) and the combined PMF score were significantly associated with HLM (OR, 0.098; 95% CI 0.034-0.257; p < 0.001) were significantly associated with HLM in univariable analysis. In multivariable analysis, only the combined PMF score remained independently associated with HLM. The PMF score-only model showed an area under the curve of 0.794 (95% CI 0.709-0.879), with a Youden-derived threshold of ≤ 1.0, sensitivity of 58.5%, specificity of 86.8%, and accuracy of 72.6%.Conclusions The combined PMF score was the MRI-derived marker most consistently associated with arthroscopically confirmed HLM. In this selected surgical cohort, lower combined PMF scores showed acceptable discrimination and relatively high specificity, although sensitivity was modest. Accordingly, a combined PMF score of ≤ 1.0 may provide adjunctive MRI information that raises suspicion for HLM when the clinical presentation is suggestive, but it cannot exclude HLM or independently establish the diagnosis, and the decision to perform arthroscopy should not be based on the score alone. Arthroscopic dynamic assessment remains necessary for definitive confirmation.
SN - 2234-0726
SN - 2234-2451
ER -