 Let's take this 22-year-old man with Tourette's syndrome who has unrestricted facial movements and look at his gradient echo on the left and his T1 anatomic image on the far right. The meniscus should have three components to it, an anterior band, an intermediate zone, and a flared posterior band. Where is the flared posterior band? The meniscus looks like it's a little curvy or a little scrunched up, instead of having this by concave appearance. Another question you might ask yourself is, where are the attachments? Is there one up there? We certainly don't see the lower attachment. So perhaps we ought to scroll a little bit on either side and see if we can identify the attachments. So I'm going to scroll the T1 a little bit. I'm going to go towards the medial aspect of the condo. You can see where my line is moving. Then I'm going to go back out laterally, all the way to the outside, and I still have a little bit of meniscal tissue there. So the anterior band is a little bit laterally displaced, because we're seeing it a little too far out. Now we go to the middle of the meniscus, and we're still having trouble locating a good quality flared posterior band. This is not the sequence that you would use to look at the attachments. This one is, especially in the open mouth view. So let's go to the open mouth view and see if those attachments show up, and where is our posterior band, and does it capture? Let's keep going. We're opening the incisors by using tongue depressors to separate the teeth, and the condyle is rotating and translating forward. It's still moving forward. It's still moving forward, and now our posterior band is starting to take some shape, a lot like the bow tie that you would wear with your tuxedo. There's the right side of the bow tie. There's the left side of the bow tie, or posterior and anterior, with intermediate zone. So wow, it does capture. It does show up, but it's still a little bit ill-defined. And the upper attachment is oh, so thin and barely visible. The lower attachment, right there, not so much. Lower attachment is off. So this patient has internal derangement, a partial internal derangement. They eventually capture and achieve this shape. In other words, the medibular condyle forward with the bow tie at least 50% to 60% behind the 12 o'clock position, and so it goes right there. So there is capture, therefore partial derangement with swelling of the posterior band, swelling throughout the bilaminar zone, and a little bit of sideways displacement laterally of the meniscus. Now you could have sideways displacement medially, or you could have sideways displacement laterally. You could also have rotational displacement, which is antrometial or antrolateral, and this one is rotational displacement. It's antrolateral. So there are three teaching points here. The first one we've already illustrated, partial derangement with capture. The second teaching point, in the closed mouth view, the posterior band ill-defined, because it's swollen, but anterior. What we can define is anterior to the 12 o'clock position of the medibular condyle C prior vignette for establishing the 12 o'clock position in an antiverted condyle. And then finally, the last teaching point in this case is that sometimes this tissue may become thick and maybe not so gray, but scarred and dark, dark like the meniscus or disk. So you may have a meniscus that's too long. In other words, the meniscus looks something like this. Looks okay, and then all of a sudden some other tissue gets in there of the same signal intensity, but it keeps going. Makes a little mass like that, and you're looking at scar tissue in the attachments that elongate the meniscus and make it look like it's in the right position. Because this area would be dark, this area would be dark, and this area would be dark. This is known as the pseudo disk pitfall. Now I'm gonna show you in a separate vignette the contralateral side in this patient with Tourette syndrome. This is an example, swollen, posterior portion of the meniscus, anterior displacement, swollen retro meniscal pad, capture with mouth opening in a 22 year old band.