Findings: MRI of the right knee: A bucket handle tear is present in the lateral meniscus. The bucket handle tear fragment is displaced anteriorly. A moderate joint effusion is also noted.

Diagnosis: Bucket handle tear of the lateral meniscus.

Discussion: A bucket handle tear is a vertical, longitudinal tear that can result in the inner free edge of the meniscus becoming displaced into the intercondylar notch. These kinds of tears most frequently occur within the medial meniscus. A bucket handle tear effectively reduces the width of the meniscus and is most easily recognized by observing on the sagittal images that only one image has the "bow tie" appearance indicating intact body of the meniscus. A normal meniscus is approximately 10 to 12 mm in width and if sagittal images are obtained at 4 to 5 mm intervals, the bow tie shape of the meniscus is generally seen on two contiguous sagittal images. On the coronal images a bucket handle tear may show the meniscus to be shortened and truncated. However, as the torn meniscus remodels the truncation may not be appreciated. The displaced meniscal fragment, the handle of the bucket, is often found the intercondylar notch and may be seen on sagittal or coronal images.

Reference:
Helms C. Fundamentals of Skeletal Radiology. W.B. Saunders,
Company; Philadelphia, 1995:175-178.

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