Bucket  Handle  Tear

A displaced longitudinal meniscal tear is termed a bucket handle tear since the displaced central fragment resembles the handle of a bucket. They frequently occur in younger patients secondary to significant trauma and there may be an associated ACL tear. The displaced fragment often lies in the intercondylar notch, anterior to the posterior cruciate ligament (PCL), as seen in example 1, and may cause a locked knee or lack of full extension. The medial meniscus is most commonly involved.

Example 1: Large bucket handle tear of medial meniscus.
Key: ACL, PCL anterior and posterior cruciate ligaments; MCL, LCL medial and lateral collateral ligaments.
Sagittal T1 and T2* images together with coronal proton density weighted images are shown:

Example 2 shows a large bucket handle tear of the posterior horn of the lateral meniscus. The posterior horn has flipped forward and come to rest anterior to the anterior horn with absence of meniscal tissue posteriorly.
Sagittal T2* and T1 with magnified views are shown: