Ramp Lesion

Demographic and clinical details: 15 years old male who had trauma history 3 months ago admitted with right knee pain.

İmage Detail: Consecutive sagittal  fat suppressed proton density images demonstrate peripheral longitudinal tear of the capsular attachment of the posterior horn of the medial meniscus at the meniscocapsular junction extending into the tibial and femoral articular surfaces. This tear pattern is consistent with ramp lesion. There is also associated meniscocapsular edema (fig. 2 (arrow) (Look at Photos section) and complete tear of anterior cruciate ligament (fig.3 (arrow) (Look at photos section)). 

Ramp lesions occur usually in the setting of ACL tears as in this case. Identification of ramp lesion important since it has a hidden location using standard anterolateral and anteromedial arthroscopic portals, its identification guides the orthopedic surgeon to identify it on arthroscopy by probing of the posterior horn of the medial meniscus, which may require an additional portal

In my experience sagittal and axial planes are important for identification of ramp lesions.