Discoid meniscus: a cause of knee pain in children
In the knee joint of each of us there are two meniscus, they are internal meniscus and external meniscus, these structures play role in the distribution of power transmission from the femur to the tibial plateau, it can be understood roughly as a damping in the joints. Normally meniscus has structures as C 1, also described as the crescent. In children, cartilage structure is quite tough and firm so it is relatively difficult to injure when the knee is injured, compared with the structure of ligaments. However, meniscus injury risk is higher and more troubling when structural abnormalities. The most common abnormality in the structure of the meniscus is ‘Discoid meniscus’.
Discoid meniscus is an abnormal morphology of the meniscus, which is usually caused by congenital form or meniscus is in dished or circled shape instead of the crescent one. Due to abnormal morphology, ‘Discoid meniscus’ is easy to be vulnerable than normal meniscus, but some patients having ‘Discoid meniscus’ have almost no symptoms throughout life and only accidentally discovered while knee magnetic resonance examination for another reason.
Discoid meniscus is common in external meniscus, very rare in internal meniscus. Prevalence of ‘Discoid meniscus’ according to medical literature accounts from 1% to 3% of the population and about 20% of cases having ‘Discoid meniscus’ often meet in two sides of the knee.
In terms of injuries, ‘Discoid meniscus’ has three types: not completely, totally and type having mobile ligament Wrisberg, this ligament plays a role in keeping meniscus and tibial plateau when damaged, if don’t have it, the meniscus will mobile excessive easy making pain and jams joints.
Discoid meniscus is more vulnerable than normal meniscus by abnormal structures that is easy to get stuck when the knee move creating pain and torn cartilage. In the case of the ligament anchor meniscus and tibial plateau loose or has no, this risk is higher. When injured, including the normal meniscus is also very difficult to become normal due to poor blood vessel structure.
The cause of ‘Discoid meniscus’ is not really clear, some authors suggest that there is an abnormality in the development of the fetus makes meniscus stretching and forming in a disc-shaped structure. This cartilage injury is more frequent when twisted knee such as change direction. However, in some cases, it is impossible to determine the mechanism of injury obviously.
The main symptoms of ‘Discoid meniscus’ can meet (by tearing or not) such as: pain, limited movement or swollen knee, knee jammed or not fully stretched. Meniscus injury is common in young adolescents if after one knee injury or in the absence of a clear history of trauma but the patients’ expression is as above, excluding the original other internal causes, should be examined to determine whether having ‘Discoid meniscus’ or not.
In terms of diagnosis, clinical symptoms are only suggestive. Definitive diagnosis is based on a scan of knee MRI to determine the extent and form lesions.
In terms of treatment, in case of accidental discovery through knee MRI, if the patient has no clinical nuisance, they may not need to intervene and continue living with it. In case of clinical symptoms, surgery is necessary. Surgery was performed by laparoscopy for cutting and shaping the meniscus structure similar to normal. In some cases, the meniscus teared can also be sewn. However, it depends on an assessment of damage in surgery.
After surgery, patients can wear the soft brace, crutches to support in a certain time and then return to normal activities. Some cases may have to rehabilitate if the knee is limited in stretching in a long time. Most patients can return to normal activity, however, in some cases having seriously hurt, the patient remains pain and has a risk of early osteoarthritis.
In this article, we gave some information about ‘Discoid meniscus’- a cause of knee pain in children that is very useful to help you have more knowledge to early identify and intervene this disease. Hope you are pleased with the article.