<transcript><audio_36>this it's this and it's all this tissue too much grey thick tissue and by the way look at the capsule little wavy isn't it the wavy line sign that capsule got dinged a little bit too</transcript><transcript><audio_37>what great as you know just with PI rads and buyer ads you know grades don't always work so you would call this a grade one however most advocates of ramp lesions feel that when you lose the</transcript><transcript><audio_38>inferior Misco tibial ligament that it's a more serious type of ramp injury so classically this would be a ramp one involving the capsule but as I said earlier it's a ramp one plus because you've got the capsule and you've got</transcript><transcript><audio_39>this meniscus to be a ligament that's affected which is usually affected with higher grades of ramp lesion so it doesn't perfectly fit in to any one of the ramp lesion categories one through five what do I think about the anterior</transcript><caption><image_40>The image is a collage of three black and white MRI images of a human body. The images are arranged in a grid-like pattern, with each image overlapping the one below it.

The first image on the left shows the left side of the image, which appears to be a close-up of the brain. The brain is shown in a grayish-white color, while the other two images on the right side are in a darker gray color. The image is taken from a top-down perspective, with the left and right sides of the images overlapping each other. The left side shows the brain in a more prominent position, with a small amount of blood vessels visible in the center. The right side shows a larger area in the middle, which is likely the location of the blood vessels in the brain, and a smaller area on the bottom left side, which could be a blood vessel or a vein in the lower part of the body.
- The image also has a blue line in the top right corner, which may be a label or a label that may indicate the location or location of a specific medical or medical device.</caption><transcript><audio_41>horn of the lateral meniscus I didn't think much about it but let's let's have another look at it here it is now the anterior horn of the lateral meniscus is really a problematic area and here's why so nice C shaped lateral</transcript><transcript><audio_42>meniscus a little thinner up front so not as wide here as it is back here it's pretty long it's got a long tongue in the front the medial meniscus is usually more C shaped now when you get to the</transcript><transcript><audio_43>front of the lateral meniscus remember that the ACL is coming right to it and the root ligaments are going to blend with the ACL but another thing happens these root attachments and the capsular reflexion interdigitate s--</transcript><transcript><audio_44>with the anterior lateral horn and gives you plenty of horizontal signal so if you look at the meniscus laterally sometimes it'll look like this you'll see a little wisp in it this is at the</transcript> this it's this and it's all this tissue too much grey thick tissue and by the way look at the capsule little wavy isn't it the wavy line sign that capsule got dinged a little bit too what great as you know just with PI rads and buyer ads you know grades don't always work so you would call this a grade one however most advocates of ramp lesions feel that when you lose the inferior Misco tibial ligament that it's a more serious type of ramp injury so classically this would be a ramp one involving the capsule but as I said earlier it's a ramp one plus because you've got the capsule and you've got this meniscus to be a ligament that's affected which is usually affected with higher grades of ramp lesion so it doesn't perfectly fit in to any one of the ramp lesion categories one through five what do I think about the anterior horn of the lateral meniscus I didn't think much about it but let's let's have another look at it here it is now the anterior horn of the lateral meniscus is really a problematic area and here's why so nice C shaped lateral meniscus a little thinner up front so not as wide here as it is back here it's pretty long it's got a long tongue in the front the medial meniscus is usually more C shaped now when you get to the front of the lateral meniscus remember that the ACL is coming right to it and the root ligaments are going to blend with the ACL but another thing happens these root attachments and the capsular reflexion interdigitate s-- with the anterior lateral horn and gives you plenty of horizontal signal so if you look at the meniscus laterally sometimes it'll look like this you'll see a little wisp in it this is at the
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