Musculoskeletal Imaging • Original Research

Peduto et al.
MR Arthrography of Popliteomeniscal Fascicles
Musculoskeletal Imaging
Original Research

Popliteomeniscal Fascicles:
Anatomic Considerations Using
MR Arthrography in Cadavers
Anthony J. Peduto1,2 OBJECTIVE. This study was performed to examine the normal MR arthrographic anat-
Alison Nguyen1 omy of the popliteomeniscal fascicles with specific reference to the number of popliteomenis-
Debra J. Trudell1 cal fascicles, thickness and course of the fascicles, and presence of other posterior attach-
Donald L. Resnick1 ments from the medial aponeurosis of the popliteus musculotendinous region.
Materials and methods. Multiplanar 1.5-T MR arthrography of 10 cadaveric
Peduto AJ, Nguyen A, Trudell DJ, Resnick DL knees was performed using a quadrature knee coil. Specimens were frozen and sectioned in
the sagittal (n = 4), axial (n = 3), and coronal (n = 3) planes. MR images and anatomic speci-
mens were correlated by two musculoskeletal radiologists.
RESULTS. Three popliteomeniscal fascicles were identified on MR arthrography: an-
teroinferior and posterosuperior fascicles in all 10 knees and posteroinferior fascicles in four
of the knees. The posterosuperior popliteomeniscal fascicle was uniform in thickness, and the
anteroinferior popliteomeniscal fascicle was variable in thickness. The anteroinferior poplit-
eomeniscal fascicle formed a conjoined fibular attachment with the popliteofibular ligament.
A medial aponeurotic extension from the popliteus musculotendinous region gave rise to the
posteroinferior popliteomeniscal fascicle, which extended upward and attached to the infero-
medial aspect of the posterior horn of the lateral meniscus. Additional attachments from the
medial aponeurosis of the popliteus musculotendinous region to the posterior cruciate liga-
ment, posterior capsule, oblique popliteal ligament, and posterior meniscofemoral ligament
of Wrisberg were seen.
CONCLUSION. Three popliteomeniscal fascicles were identified on MR arthrographic im-
ages. The popliteus muscle–tendon unit forms robust attachments in the superior, inferior, medial,
and lateral oblique aspects, highlighting its importance in posterolateral stability of the knee.

B
etter understanding of the clini-
cal significance of injuries to the
posterolateral corner of the knee
has led to an increasing focus on
clinical evaluation, treatment, and MRI of
Keywords: anatomy, fascicles, knee, MRI, this region. Unrecognized injuries to the
popliteomeniscal posterolateral corner have been cited as an
important factor in postsurgical failure after
DOI:10.2214/AJR.07.2643
cruciate ligament reconstruction and in chron-
Received May 29, 2007; accepted after revision ic instability and degenerative changes after
July 10, 2007. knee trauma [1, 2]. Within the posterolateral
1
corner of the knee, the functional and struc-
Department of Radiology, Veterans Affairs Healthcare
System, San Diego, CA.
tural relations among the lateral meniscus,
popliteus muscle and tendon attachments, and
2
Department of Radiology, Westmead Hospital, Darcy the popliteomeniscal fascicles have received
Rd., Westmead, Sydney, New South Wales, Australia considerable emphasis [3–7].
2145. Address correspondence to A. J. Peduto.
The proximal intraarticular insertion of the
AJR 2008; 190:442–448 popliteus tendon is situated within a shallow
concavity in the lateral aspect of the femur
0361–803X/08/1902–442
designated the popliteal sulcus. The tendon
© American Roentgen Ray Society descends in an inferoposterior helicoid man-
ner to the posterolateral corner of the knee. As
it passes the posterior horn of the lateral me-
niscus, the popliteus tendon becomes extraar-
ticular. The popliteomeniscal fascicles are
posterolateral meniscocapsular extensions
that blend inferiorly into the popliteus muscu-
lotendinous region and allow the tendon to
pass from an intraarticular to an extraarticular
compartment while maintaining the compart-
mental integrity of the knee joint. The poplit-
eomeniscal fascicles are considered function-
ally important stabilizers of the lateral menis-
cus, working in conjunction with the popliteus
musculotendinous unit to prevent excessive
lateral meniscal movement and possible en-
trapment [8–10]. Injuries to the popliteome-
niscal fascicles are commonly underrecog-
nized both clinically and on imaging studies
and are reported [3, 9] to occur in association
with acute anterior cruciate ligament tears in
as many as 25% of patients. Isolated tears of

442 AJR:190, February 2008

 MR Arthrography of Popliteomeniscal Fascicles
Fig. 1—Drawing shows superolateral view
of posterolateral corner of knee with femur
and superficial fibular attachments removed.
Arrangement between popliteus muscle (8)
and tendon (9) (cut proximally and reflected)
and anteroinferior (11) and posterosuperior (10)
popliteomeniscal fascicles is apparent. Inferolateral
portion of anteroinferior popliteomeniscal fascicle
(11) forms common fibular styloid attachment
with anterior arm of popliteofibular ligament
(6). 1 = anterior cruciate ligament, 2 = posterior
cruciate ligament, 3 = lateral meniscus, 4 = anterior
meniscofemoral ligament of Humphry, 5 = posterior
meniscofemoral ligament of Wrisberg, 7 = posterior
arm of popliteofibular ligament, 12 = fibula. (Reprinted
with permission from Stäubli HU, Birrer S. The
popliteus tendon and its fascicles at the popliteal
hiatus: gross anatomy and functional arthroscopic
evaluation with and without anterior cruciate
ligament deficiency. Arthroscopy 1990; 6:209–220 [3])
the popliteomeniscal fascicles can be symp-
tomatic and manifest as localized posterolat-
eral pain and locking of the knee joint [8, 10,
11]. Some authors [11] have referred to this
disorder as hypermobile lateral meniscus and
describe specific clinical examination tech-
niques that can help in the diagnosis.
Although there is debate about the number
of popliteomeniscal fascicles, most studies
have described at least two: an anteroinferior
fascicle and a posterosuperior fascicle [3, 7,
12, 13]. The anteroinferior popliteomeniscal
fascicle originates from the lateral aspect of
the body of the lateral meniscus, courses in
an inferoposterior direction to form the floor
of the popliteal hiatus, and then blends with
the musculotendinous portion of the popli-
AJR:190, February 2008 443
teus muscle. The lateral portion of the an-
teroinferior popliteomeniscal fascicle takes
an inferoposterior course and fuses with the
popliteofibular ligament to form a conjoined
attachment at the fibular styloid process. The
origin of the posterosuperior popliteomenis-
cal fascicle is the posterosuperior margin of
the posterior horn of the lateral meniscus
medial to the popliteus tendon. This fascicle
forms the roof of the popliteal hiatus.
The posterosuperior popliteomeniscal fasci-
cle has a posterior course and attaches to the
posterior joint capsule, which fuses with the
musculotendinous portion of the popliteus
tendon (Fig. 1).
The presence of a third popliteomeniscal
fascicle, known as the posteroinferior poplit-
eomeniscal fascicle, is controversial. This
fascicle is reported to be located medial to
the popliteal hiatus [11, 14–16]. Last [17] in
1950 described a broad and robust aponeu-
rotic extension from the medial aspect of the
musculotendinous region of the popliteus
muscle that had a prominent attachment to
the inferior margin of the posterior horn of
the lateral meniscus. Terry and LaPrade [15]
and Ullrich et al. [16] also described the me-
dial aponeurotic extension and designated
the attachment to the inferior margin of the
posterior horn of the lateral meniscus the
posteroinferior popliteomeniscal fascicle.
This fascicle passes upward from the medial
aponeurosis of the popliteus muscle and in-
serts on the inferior margin of the posterior
horn of the lateral meniscus near the origin
of the posterior meniscofemoral ligament of
Wrisberg. Feipel et al. [14] found the postero­
inferior popliteomeniscal fascicle present in
17% of 42 dissections of embalmed knee
specimens. Most other reports of the postero­
inferior popliteomeniscal fascicle do not
state its frequency.
The medial aponeurosis of the popliteus
musculotendinous region has been reported
to have additional medial attachments to the
inferolateral aspect of the posterior cruciate
ligament, the posterior capsule, and an
infero­lateral connection with the oblique
popliteal ligament [14, 16]. A variant of the
posterior meniscofemoral ligament of Wris-
berg has been reported in which the origin is
the medial aponeurosis of the popliteus mus-
culotendinous region rather than the posteri-
or horn of the lateral meniscus [14].
This study was performed to examine the
normal MR arthrographic imaging anatomy
of the popliteomeniscal fascicles with specific
reference to the number of popliteomeniscal
fascicles, the thickness and course of the fas-
cicles, and the presence of other posterior at-
tachments from the medial aponeurosis of the
popliteus musculotendinous region.
Materials and Methods
After institutional review board approval was
obtained, 10 fresh unembalmed frozen cadaveric
knee specimens were obtained from the
department of anatomy donor program at our
institution. Specimens were from five men and
five women whose average age at death was 85
years (range, 73–93 years).
MR Arthrography
Before MRI, specimens were allowed to thaw
to room temperature for 24 hours, after which
arthrography was performed under fluoroscopic
guidance. Approximately 55–60 mL of a solution
containing 1 mL of gadopentetate dimeglumine
(Magnevist, Bayer Schering Pharma) diluted in
250 mL of equal parts saline solution and iohexol
(Omnipaque 350, GE Healthcare) was injected
into each knee joint via a lateral suprapatellar
approach with an 18-gauge needle. T1-weighted
spin-echo imaging was performed on a 1.5-T
MRI system (Signa LX Horizon, software version
8.3, GE Healthcare) with a quadrature knee coil
in the orthogonal sagittal, axial, and coronal
planes. The following MRI parameters were used:
TR/TE, 900/22; bandwidth, 16 kHz; matrix size,
512  ×  256; field of view, 12  ×  12 cm; slice
thickness, 2.5-mm; interslice gap, 0.5 mm; single
acquisition; imaging time, approximately 5
minutes for each sequence.
Specimen Sectioning and Photography
After MRI, the knee specimens were placed in a
freezer (Forma Bio-Freezer, Forma Scientific) and
deep frozen to −40°C. The frozen knee specimens
were sectioned with a band saw into 3-mm slices
in the sagittal (n = 4), axial (n = 3), and coronal
(n =  3) planes. After debris was rinsed from the
surface of the specimens, the sections were
thawed, floodlit, and photographed with a digital
camera (Coolpix 990, Nikon).
Image Interpretation
MR arthrographic images and specimen
photographs were simultaneously reviewed by two
musculoskeletal radiologists working in consensus.
Identification and location of the anteroinferior,
posterosuperior, and postero­­inferior popliteo­
meniscal fascicles and the medial aponeurosis with
its medial attachments were based on gross
anatomic descriptions obtained from the literature
[3, 12, 14–16]. The number of popliteomeniscal
fascicles visualized and their location on MR
 Peduto et al.

arthrographic images were recorded for each
specimen. The reviewers inspected MR arthro­
graphic images obtained through the popliteal
hiatus, with the anteroinferior popliteomeniscal
fascicle originating from the lateral surface of the
body of the lateral meniscus and forming the floor
and lateral wall of the hiatus, and the posterosuperior
popliteomeniscal fascicle originating from the
superior edge of the posterior horn of the lateral
meniscus and forming the roof and medial wall of
the hiatus. MR arthrographic images obtained
medial to the popliteal hiatus were inspected for the
presence of a medial aponeurotic extension from the
musculotendinous junction of the popliteus muscle,
which has been reported [15–17] to send an
attachment to the inferior edge of the posterior horn
of the lateral meniscus. This attachment is designated
the posteroinferior popliteomeniscal fascicle and is
immediately beneath the origin of the meniscofemoral
ligament of Wrisberg.
Electronic calipers were used to measure the
thickness of each popliteomeniscal fascicle on
MR arthrographic images. The fascicles were
categorized as thin (≤ 1 mm), intermediate (1–2
mm), or thick (≥ 2 mm). The following anatomic
features were recorded: presence of a popliteofibular
ligament and its relation to the anteroinferior
popliteomeniscal fascicle, presence of a medial
aponeurotic extension from the popliteus
musculotendinous unit, and presence of medial
attachments from the medial aponeurosis to the
posterior cruciate ligament, posterior joint capsule,
oblique popliteal ligament, and the posterior
meniscofemoral ligament of Wrisberg.

Results
The anteroinferior and posterosuperior popli-
teomeniscal fascicles were identified with MR
arthrography in all 10 specimens. Together
the anteroinferior and posterosuperior poplit-
eomeniscal fascicles formed a meniscocapsular
sheath enveloping the popliteal tendon as it
A B passed through the popliteal hiatus and be-
came extraarticular in location (Fig. 1).
The anteroinferior popliteomeniscal fasci-
cle (Fig. 2) extended in an inferoposterior di-
rection from its attachment at the lateral aspect
of the body of the lateral meniscus and formed
the lateral wall and floor of the popliteal hia-
tus. The thickness of the anteroinferior popli-
teomeniscal fascicle was variable. In five of
10 specimens, this fascicle was categorized
as thick, in three as intermediate, and in two
as thin. The anteroinferior popliteomeniscal
fascicle curved in the inferior direction adja-
cent to the posteromedial aspect of the fibular
styloid process and blended with the poplit-
eofibular ligament to form a conjoined fibular
attachment, which was found in eight of 10
specimens (Fig. 2). In the more medial aspect
the anteroinferior popliteomeniscal fascicle
formed the floor of the popliteal hiatus and
fused with the deep musculotendinous portion
of the popliteus complex. The popliteofibu-
C D lar ligament was seen on MR arthro­graphic
Fig. 2—Anteroinferior popliteomeniscal fascicle and popliteofibular ligament of cadaver specimens. A and B images of nine of 10 specimens and had a ro-
are matching MRI and anatomic sections from one cadaver; C and D are matching MRI and anatomic sections
bust attachment to the posteromedial aspect
from another cadaver.
A–D, Sagittal T1-weighted MR arthrographic images with corresponding cadaveric sections show of the fibular styloid process (Fig. 2). Only a
anteroinferior popliteomeniscal fascicle extending in posteroinferior course from lateral aspect of lateral single attachment site of the popliteofibular
meniscus (LM) and to blend with popliteus tendon. Conjoined attachment of anteroinferior popliteomeniscal ligament was discernible.
fascicle and popliteofibular ligament (asterisk) at styloid process of fibula (f) is evident. Variable appearance
of anteroinferior popliteomeniscal fascicle (arrows) is thin and membrane-like in A and B and thick in C and D. The posterosuperior popliteomeniscal fas-
POP = popliteus tendon. cicle was in a medial position in relation to

444 AJR:190, February 2008

 MR Arthrography of Popliteomeniscal Fascicles

A B C

D E F

Fig. 3—Popliteomeniscal fascicular attachments of cadaver specimen.

A–G, Series of sagittal T1-weighted MR arthrographic images of lateral meniscus extending from lateral to
medial shows three popliteomeniscal fascicular attachments. Anteroinferior popliteomeniscal fascicle (AI-
PMF) is thinner than posterosuperior popliteomeniscal fascicle (PS-PMF) in this knee. The posteroinferior
popliteomeniscal fascicle (PI-PMF) extends upward and in medial direction from medial aponeurotic extension
(arrowheads, F and G) of popliteus musculotendinous region and attaches to inferior margin of posterior horn of
lateral meniscus immediately below posterior meniscofemoral ligament of Wrisberg (curved arrow in G).
G

AJR:190, February 2008 445

 Peduto et al.

the popliteus tendon at the level of the diately above the diverging popliteus tendon. was uniform in thickness in all 10 of the
popliteal hiatus and extended in a posterior In this region the popliteus tendon widened specimens and was categorized as thick.
direction from the posterosuperior corner of and formed a broad aponeurotic attachment A broad medial aponeurotic expansion from
the posterior horn of the lateral meniscus with the posterior capsule, anchoring the the medial aspect of the musculotendinous
(Fig. 3) to the posterior joint capsule imme- posterior horn of the lateral meniscus to the region of the popliteus tendon was identified
popliteus muscle via the posterosuperior in all 10 specimens (Fig. 3). From the medial
popliteomeniscal fascicle and capsule. The aponeurosis an attachment to the inferior mar-
posterosuperior popliteomeniscal fascicle gin of the posterior horn of lateral meniscus
was seen that corresponded to the anatomic
descriptions by Terry and LaPrade [15] of
the third, or posteroinferior, popliteomeniscal
fascicle. The posteroinferior popliteomeniscal
fascicle was seen on MR arthrographic im-
ages of four of 10 knee specimens (Fig. 3).
All four posteroinferior popliteomeniscal
fascicles identified were categorized as thick
on measurement.
Additional attachments of the medial
aponeurosis were seen. An attachment to the
posterior joint capsule was seen on MR ar-
thrographic images of eight of the 10 knees.
A deeper extension to the inferolateral aspect
of the posterior cruciate ligament was found
in seven of the 10 specimens (Fig. 4). A focal
thickening of the medial aponeurosis coursed
A B upward, where it joined the oblique popliteal
ligament to form an inferior connection be-
Fig. 4—Attachment of medial aponeurosis to posterior cruciate ligament.
A, Axial T1-weighted MR arthrographic image shows inferomedial extension from medial aponeurosis to tween the medial aponeurosis and the oblique
inferolateral aspect (arrows) of posterior cruciate ligament (PCL). popliteal ligament in seven of the 10 speci-
B, Axial section of different specimen from A with traction on medial aponeurotic extension of popliteus mens (Fig. 5). In one knee in which both the
muscle–tendon unit shows attachment to posterior cruciate ligament (arrows). POP = popliteus tendon.
anterior and posterior meniscofemoral liga-
ments were present, the medial aponeurotic
extension from the popliteus musculotendi-
nous region extended medially to form the
posterior meniscofemoral ligament of Wris-
berg (Fig. 5). In this knee, the anterior me-
niscofemoral ligament of Humphry had a
normal attachment to the posterior horn of
the lateral meniscus.

Discussion
There has been increasing interest in the
meniscocapsular attachments of the popliteus

A B
Fig. 5—Medial aponeurosis attachments of
cadaver specimen. Series of axial T1-weighted MR
arthrographic images from inferior (A) to superior (D)
aspects. PCL = posterior cruciate ligament.
A, MR arthrographic image shows relation between
popliteus tendon (POP) and medial aponeurosis
(arrowheads). Medial attachments to posterior
capsule (large arrow) and ligament of Wrisberg (small
arrow) extend from medial aponeurosis. LM = lateral
meniscus.
B–D, Successive superior MR arthrographic images
show Wrisberg extension (short arrows) of medial
aponeurosis can be followed upward. Upward
extension of medial aponeurosis (arrowheads)
forms inferior connection with oblique popliteal
ligament (long arrows, D). Asterisk (B and C) indicates
meniscofemoral ligament of Humphry.
C D

446 AJR:190, February 2008

 MR Arthrography of Popliteomeniscal Fascicles
muscle–tendon complex. These attachments
not only are important in allowing the tendon
to pass through the joint capsule to assume an
extraarticular location but also act in concert
with the popliteus complex to retract the lat-
eral meniscus from the joint during knee flex-
ion to prevent excessive meniscal shearing
forces and entrapment [8–10]. A number of
studies [3, 9] have shown a relatively high
prevalence of disruption of the popliteomenis-
cal fascicle at arthroscopic surgery on patients
with anterior cruciate ligament tears.
In this series, the anteroinferior and pos-
terosuperior popliteomeniscal fascicles were
seen on all MR arthrographic studies. In com-
parison, Feipel et al. [14] found the anteroinfe-
rior popliteomeniscal fascicle in 83% and the
posterosuperior popliteomeniscal fascicle in
90% of dissections of 42 embalmed knee
specimens. Terry and LaPrade [15] and Stäub-
li and Birrer [3] described the presence of
these fascicles in their studies of 30 and 14
fresh cadavers, but they did not discuss how
frequently the fascicles were seen in the spec-
imens. In arthroscopic studies [3, 15, 18], the
anteroinferior and posterosuperior poplit-
eomeniscal fascicles have been reported to be
present in nearly all patients examined. Tria et
al. [19], unlike most other investigators, found
fascicular attachments to the lateral meniscus
in only 22 of 40 knee dissections.
In our study, unlike the posterosuperior
popliteomeniscal fascicle, which had uniform
thickness, the anteroinferior popliteomeniscal
fascicle had variable thickness, ranging from a
thin membrane-like structure to a much more
robust structure. Bozkurt et al. [20] described
a lateral meniscofibular ligament that appeared
to correspond to the anatomic description of
the anteroinferior popliteomeniscal fascicle in
all 50 specimens examined by microdissec-
tion and transillumination. We found the lat-
eral portion of the anteroinferior popliteome-
niscal fascicle passed downward and in a lat-
eral direction to form a conjoined attachment
with the popliteofibular ligament at the fibular
styloid process, resulting in a connection be-
tween the lateral aspect of the body of the lat-
eral meniscus and the styloid process of the
fibula that matched the description of a menis-
cofibular ligament by Bozkurt et al.
Terry and LaPrade [15] described a third
popliteomeniscal fascicle designated the
posteroinferior popliteomeniscal fascicle,
which extended from the medial aponeurotic
extension of the popliteus tendon to attach to
the inferior margin of the posterior horn of
the lateral meniscus. The posteroinferior
AJR:190, February 2008 447
popliteomeniscal fascicle was seen in 40%
of the knees in our study compared with 17%
of those studied by Feipel et al. [14]. Ullrich
et al. [16] found a third popliteomeniscal fas-
cicle in their dissections of 13 fresh knees,
but the frequency of the finding of a postero-
inferior popliteomeniscal fascicle was not
stated. Inconsistencies in descriptions of the
third popliteomeniscal fascicle and doubts
about its existence may relate to studies con-
centrated solely on the popliteal hiatus region
without consideration of the more medially
located capsular aponeurotic extension from
the popliteus tendon and its complex poster-
omedial attachments. Last [17], in a report
on the popliteus complex in 1950, described
the broad medial aponeurotic extension from
the medial portion of the popliteus muscle
with a prominent attachment to the inferior
margin of the posterior horn of the lateral
meniscus. This description corresponds to
other descriptions of the posteroinferior
popliteomeniscal fascicle.
The medial aponeurotic extension of the
popliteus muscle appears to be an important
structural element of the popliteus complex. In
addition to blending with the posterior capsule,
this extension forms an inferior connection
with the popliteal oblique ligament, sends at-
tachments to the posterior cruciate ligament
and posterior horn of the lateral meniscus
(posteroinferior popliteomeniscal fascicle),
and in some individuals gives origin to a vari-
ant of the ligament of Wrisberg. Thus the pop­
liteus muscle–tendon complex has attachments
that form a robust-appearing cruciate arrange-
ment: a superior attachment to the femur at the
popliteal sulcus, an inferior triangular attach-
ment of the main muscle bulk to the posterior
aspect of the tibia, a robust inferolateral attach-
ment to the fibular styloid process via the
popliteofibular ligament, and several complex
superomedial attachments to the joint capsule,
lateral meniscus, oblique popliteal ligament,
and ligament of Wrisberg. The importance of
the popliteus muscle–tendon unit is highlight-
ed by these robust-appearing attachments and
by study findings [16, 21, 22] of dynamic and
static functions that include balancing and
controlling neutral tibial rotation, acting as a
principal dorsolateral knee stabilizer, and pre-
venting lateral meniscal entrapment during
knee flexion by retraction of the meniscus
via popliteomeniscal fascicle attachments.
Limitations of this study included the rela-
tively small number of specimens, allowing
only limited comment on the frequency of
variations in the attachments of the popliteus
complex. In addition, the cadavers were those
of elderly persons (average age at death, 85
years). In most specimens, moderate degen-
erative joint disease was present, with variable
areas of articular surface wear and meniscal
degeneration or tearing. These changes might
have affected visualization of structures on
MR arthrographic images. Ligament, capsu-
lar, and fascicular degenerative changes might
also have contributed to variability in the ap-
pearance of these structures with resultant
adaptive thickening or attenuation. No history
of knee injury or surgery was evident in any of
the knee specimens, but untreated or unre-
ported injury cannot be excluded.
Arthrographic fluid in the joints provided
excellent joint distention and optimized visu-
alization of the popliteomeniscal fascicles,
but this technique is not part of routine MRI
of the knee. In the absence of substantial
joint effusion or hemarthrosis, it is unlikely
that visualization of the popliteomeniscal
fascicles will be as optimal in nonarthro-
graphic studies of the knee. Hemarthrosis is
a common finding in patients with acute tear
of the anterior cruciate ligament, who have
been found to be at particular risk of poplit-
eomeniscal fascicle tears [3, 9]. Sakai et al.
[7] used an optimized oblique coronal plane
in combination with nonarthrographic MRI
and found the anteroinferior popliteomenis-
cal fascicle in 94.1% and the posterosuperior
popliteomeniscal fascicle in 88.2% of sub-
jects. We used all three orthogonal MR ar-
thrographic imaging planes in analysis and
did not assess the visibility of the poplit-
eomeniscal fascicles in individual imaging
planes. Our impression, however, was that
the popliteomeniscal fascicles were best seen
on sagittal MR arthrographic images.
We studied the normal MRI anatomic fea-
tures of the popliteomeniscal fascicles and
found three fascicles. The third, or posteroin-
ferior, popliteomeniscal fascicle was located
medial in relation to the popliteal hiatus and
arose from a medial aponeurotic extension of
the popliteus musculotendinous region, which
had additional capsular, oblique popliteal lig-
ament, posterior cruciate, and ligament of
Wrisberg attachments. These extensive at-
tachments, combined with femoral, tibial, and
fibular attachments, highlight the important
role of the popliteus muscle–tendon unit in the
posterolateral corner of the knee.
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