Should We Prefer Magnetic Resonance Imaging to Physical Examination in Meniscal Tears

2019 ◽  
Vol 33 (12) ◽  
pp. 1251-1255 ◽  
Author(s):  
Gökhun Arıcan ◽  
Ahmet Özmeriç ◽  
Özgür Şahin ◽  
Serkan İltar ◽  
Kadir Bahadır Alemdaroğlu
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Physical Examination ◽  
Lateral Meniscus ◽  
Meniscal Tears ◽  
Resonance Imaging ◽  
Predictive Values ◽  
Arthroscopic Findings ◽  
Meniscus Tears ◽  
Joint Line Tenderness

AbstractThe aim of this study was to compare the sensitivity, specificity, accuracy, positive and negative predictive values of magnetic resonance imaging (MRI), and clinical examination in the diagnosis of meniscus tears with the findings obtained from the knee joint arthroscopy. A retrospective study was made of 452 patients who underwent knee arthroscopy due to meniscus tears between 2012 and 2017. Physical examination was performed using the Thessaly's, McMurray's, and Joint line tenderness tests (JLTT). On preoperative MRI, medial meniscal tears were observed in 292 patients, lateral meniscal tears in 96 patients, and medial and lateral meniscal tears in 64 patients. According to the arthroscopy results, 284 patients had medial meniscal tears, 108 patients had lateral meniscal tears, and 60 patients had medial and lateral meniscal tears. Sensitivity and specificity of the JLTT was determined as 93 and 86% respectively for medial meniscal tears and 94 and 89% for lateral meniscal tears. The McMurray's test was 60% sensitive, 68% specific for medial meniscal tears (MMT), and 73% sensitive and 68% specific for lateral meniscus tears (LMT). The Thessaly's test was 93% sensitive and 87% specific for medial meniscal tears; and 94% sensitive and 88% specific for LMT. Compared with the arthroscopic findings, MRI was observed to have sensitivity of 94% for MMT and 84% for LMT. For specificity, the values were 89% for MMT and 91% for LMT. Accuracy was 89% for MMT and 86% for LMT. In comparison with the arthroscopic findings, the triple test was determined to have sensitivity of 92% for MMT and 89% for LMT. The specificity was 88% for MMT and 91% for LMT. The results of this study showed that a combination of selected physical examination methods is as sensitive as MRI in the diagnosis of meniscus tears.

scholarly journals Diagnostic Accuracy of Magnetic Resonance Imaging in the Detection of Type and Location of Meniscus Tears: Comparison with Arthroscopic Findings

2021 ◽  
Vol 10 (4) ◽  
pp. 606
Author(s):  
Seong Hwan Kim ◽  
Han-Jun Lee ◽  
Ye-Hoon Jang ◽  
Kwang-Jin Chun ◽  
Yong-Beom Park
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Meniscal Tears ◽  
Resonance Imaging ◽  
Arthroscopic Findings ◽  
Meniscus Tears

Magnetic resonance imaging (MRI) has been widely used for the diagnosis of meniscal tears, but its diagnostic accuracy, depending on the type and location, has not been well investigated. We aimed to evaluate the diagnostic accuracy of MRI by comparing MRI and arthroscopic findings. Preoperative 3.0-T MRI and arthroscopic findings from 2005 to 2018 were reviewed to determine the presence, type, and location of meniscus tears. In addition, subgroup analysis was performed according to anterior cruciate ligament (ACL) injury. The exclusion criteria were as follows: (1) Inflammatory arthritis, (2) other ligament injuries, (3) inability to classify meniscal tears due to degenerative arthritis, (4) over 90 days from MRI to surgery, and (5) incomplete data. Of the 2998 eligible patients, 544 were finally included. The sensitivity and specificity of MRI in determining medial and lateral meniscus tears were 91.8% and 79.9%, and 80.8% and 85.4%, respectively. The accuracy of MRI in the ACL-injured group was lower than that in the ACL-intact group (medial meniscus: 81.7% vs. 88.1%, p = 0.041; 72.9% vs. lateral meniscus: 88.0%, p < 0.001). MRI accuracy was low for the longitudinal tears of the posterior horn of the medial meniscus in the ACL-injured group. MRI could be a diagnostic tool for meniscus tears, but has limited accuracy in their classification of the type and location. Hence, care should be taken during arthroscopic assessment of ACL-injured patients due to low diagnostic accuracy of preoperative MRI.

Prediction of reparability of isolated semilunar lateral meniscus tears by magnetic resonance imaging

2002 ◽  
Vol 10 (4) ◽  
pp. 213-217 ◽  
Author(s):  
Yoshiki Shiozaki ◽  
Shuji Horibe ◽  
Tomoki Mitsuoka ◽  
Norimasa Nakamura ◽  
Yukiyoshi Toritsuka ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Lateral Meniscus ◽  
Resonance Imaging ◽  
Meniscus Tears

scholarly journals DIAGNOSTIC ACCURACY OF ULTRASOUND IN DETECTING MENISCAL TEARS TAKING MAGNETIC RESONANCE IMAGING AS GOLD STANDARD

2020 ◽  
Vol 2020 (1) ◽  
Author(s):  
MA Omer ◽  
SS Malik ◽  
MN Anjum ◽  
Az Riaz ◽  
R Ali
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Gold Standard ◽  
Lateral Meniscus ◽  
Meniscus Tear ◽  
Meniscal Tears ◽  
Resonance Imaging ◽  
Non Invasive ◽  
Sensitivity Specificity

Meniscal tears are mostly seen worldwide. Multiple imaging modalities are currently used to evaluate pathologic conditions of the knee. MRI can be referred as the non-invasive gold standard investigation to help establishing diagnosis of meniscal tears, but it economically unaffordable to most of patients and needs long examination times. Ultrasound is a possible alternative to MRI. It is simple, convenient and an inexpensive and non-invasive method. The use of ultrasound in identifying meniscal tears has been proposed, but its diagnostic accuracy remains controversial. The objective of the research is to define the diagnostic accurateness of ultrasound scan in detecting meniscal tears taking magnetic resonance imaging as gold standard. It was a diagnostic cross-sectional study in which 78 patients visiting Department of Diagnostic Radiology, Doctors Hospital, Lahore were included. Convenient sampling technique was used. Written informed consent was taken from all the patients. Patients were investigated with the help of ultrasound and results were noted on the designed proforma, subsequently the results were compared to the MRI scan of the knee joint. Data was entered and statistically analyzed using SPSS 21.0. Frequency tables were generated for all variables. For quantitative data like age mean and standard deviation were calculated and for qualitative data like sex and meniscal tears percentages were calculated. Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value was given. Bar and pie charts were used to present categorical data. Kappa analysis was utilized. The mean age of the patients was 38.18+12.818 years, 82.1% were males and 47.4% had sports trauma. Out of 48 medial meniscus tear on USG, 38(48.7%) were true positive and 10(12.8%) were false positive on MRI. Out of 10 lateral meniscus tear on USG, 9(11.5%) were true positive and 1(1.3%) was false positive on MRI. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of ultrasound for medial meniscus tears were 95.00%, 73.68%, 79.16%, 93.33% and 84.61% while for lateral meniscus tears were 75.00%, 98.48%, 90.00%, 95.58% and 94.87%, respectively. Study concluded that ultrasound has good diagnostic accuracy when compared with magnetic resonance imaging in detecting meniscal tears.

scholarly journals Discoid meniscus: current concepts

2020 ◽  
Vol 5 (7) ◽  
pp. 371-379
Author(s):  
Manuel Saavedra ◽  
Matías Sepúlveda ◽  
María Jesús Tuca ◽  
Estefanía Birrer
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Presentation ◽  
Lateral Meniscus ◽  
Asian Population ◽  
X Rays ◽  
Meniscal Tears ◽  
Resonance Imaging ◽  
Discoid Meniscus ◽  
Stable Fixation

Discoid meniscus is the most frequent congenital malformation of the menisci, and primarily affects the lateral meniscus; it is highly prevalent in the Asian population. The anatomic, vascular, and ultrastructural features of the discoid meniscus make it susceptible to complex tears. Discoid meniscus anomalies are described according to their shape; however, there is consensus that peripheral stability of the meniscus should also be defined. Initial workup includes plain X-rays and magnetic resonance imaging, while arthroscopic evaluation confirms shape and stability of the meniscus. Clinical presentation is highly variable, depending on shape, associated hypermobility, and concomitant meniscal tears. Treatment seeks to re-establish typical anatomy using saucerization, tear reparation, and stable fixation of the meniscus. Cite this article: EFORT Open Rev 2020;5:371-379. DOI: 10.1302/2058-5241.5.190023

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