Pereira Rafael R, Cabral João, Janeiro João, Padín José, Brito Joaquim Soares do, Goes Rodrigo A
Serviço de Ortopedia, Unidade Local de Saúde Santa Maria, Lisboa, Portugal.
Unidade de Cirurgia de Joelho e Tornozelo, Centro de Ortopedia e Traumatologia, Hospital CUF Descobertas, Lisboa, Portugal.
Rev Bras Ortop (Sao Paulo). 2025 Jun 23;60(2):1-10. doi: 10.1055/s-0045-1809514. eCollection 2025 Apr.
To describe a new sign on magnetic resonance imaging (MRI) axial images of patients with bucket-handle meniscal tears.
Of 610 consecutive patients with a surgical diagnosis of meniscal tear, those with a bucket-handle pattern were chosen, and 28 met the inclusion criteria. The most frequent mechanism was a twisting injury with or without a coronal stress (16 patients), and the injury was sports-related in 12 cases. All patients were symptomatic and had X-rays showing a preserved joint line. Next, their MRI examinations were analyzed.
The buffalo horn pattern was found in 13 patients (46.4%), occurring in either the medial or the lateral meniscus. It was the 3 most prevalent sign, after the fragment within the intercondylar notch ( = 21; 75.0%) and the absent bow tie sign ( = 17; 60.7%). We observed that it had a significant association with other signs of displaced meniscal handle. The sign was neither found on the healthy menisci, nor was affected by the occurrence of an anterior cruciate ligament tear.
The buffalo horn is a new finding for displaced meniscal bucket-handle tears; it is easy to identify and relevant in the interpretation of axial MRI images. Its recognition is very important to determine the type of treatment and the surgical plan.
描述桶柄状半月板撕裂患者磁共振成像（MRI）轴位图像上的一种新征象。
在610例经手术诊断为半月板撕裂的连续患者中，选取桶柄状撕裂模式的患者，28例符合纳入标准。最常见的机制是伴有或不伴有冠状面应力的扭转损伤（16例患者），其中12例损伤与运动相关。所有患者均有症状，X线显示关节间隙正常。接下来，对他们的MRI检查进行分析。
13例患者（46.4%）发现了牛角征，见于内侧或外侧半月板。它是第三常见的征象，仅次于髁间切迹内碎片（n = 21；75.0%）和蝴蝶结征缺失（n = 17；60.7%）。我们观察到它与半月板柄移位的其他征象有显著关联。该征象在健康半月板上未发现，也不受前交叉韧带撕裂发生情况的影响。
牛角征是半月板桶柄状移位撕裂的一个新发现；它易于识别，在轴位MRI图像解读中具有相关性。其识别对于确定治疗类型和手术方案非常重要。
