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April 30, 2026

Does flexion MRI improve the diagnosis of meniscal ramp lesions in children?

Manon Bolzinger Chloé Ravot Joe Rassi Julie Vial Emilie Auditeau Jérôme Sales de gauzy Franck Accadbled

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Key Points

This study aims to determine whether knee MRI in flexion improves the diagnosis of meniscal ramp lesions compared to MRI in extension.
Prospective comparative study of 62 patients aged 10-18 with knee MRI in both extension and flexion before ACL reconstruction.
Diagnostic accuracy assessed through sensitivity and specificity of MRI results, compared against arthroscopic confirmation.
Outcome measures included fluid interposition and infiltration behind the meniscus.
Flexion MRI identified 9 out of 11 ramp injuries (sensitivity 82%, specificity 65%), while extension MRI identified only 3 (sensitivity 27%, specificity 92%).
Flexion MRI showed better agreement with arthroscopy compared to extension MRI (p=0.05 vs p=0.16).
18 false positives were noted with flexion MRI, including different types of meniscal tears.

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Implication

Prospective comparative study examines the effectiveness of flexion MRI for diagnosing ramp lesions in youth, indicating improved detection rates.

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Cite This Study

Bolzinger et al. (2026) studied this question.

synapsesocial.com/papers/69f9892215588823dae17ff2 https://doi.org/10.1016/j.otsr.2026.104734

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Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

1Prevalence and MRI Detection of Ramp Lesions in ACL-Deficient Knees: A Prospective Study2025
2Meniscal Ramp Lesions Are More Commonly Detected on Magnetic Resonance Imaging Than Arthroscopy in Patients With Anterior Cruciate Ligament TearsCohort Study · 2026
3MRI-based predictors of MRI-detected ramp lesions in ACL-injured knees: an exploratory logistic regression and machine learning modelOriginal Research · 2026
4Enhanced Detection, Using Deep Learning Technology, of Medial Meniscal Posterior Horn Ramp Lesions in Patients with ACL Injury2025 · 3 citations
5Magnetic Resonance Imaging Evaluation of Meniscal Ramp Lesions and their Association with Anterior Cruciate Ligament Injury Severity: A Retrospective Observational StudyCohort Study · 2026