Accuracy of hand-held ultrasound scanning in detecting meniscal tears

Shetty, Asode Ananthram; Tindall, Alistair; James, Kyle; Relwani, Jai; Fernando, K. W. K.

doi:10.1302/0301-620x.90b8.20189

Cited by 36 publications

(26 citation statements)

References 9 publications

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“…[4][5][6][7][8][9] Reported sensitivities for ultrasonographic diagnosis of meniscal tears range from 83.3 to 100% and reported specificities range from 69.2 to 95%. [4][5][6][7][8][9] Differences in sensitivity and specificity among studies likely stem from variations in patient population, ultrasonographer's technique and level of expertise, and the reference standard used. In the study by Cook et al comparing ultrasonography and MRI for diagnosis of meniscal pathology in patients with acute knee pain, they reported a sensitivity of 91.2% and specificity of 84.2% for ultrasonography compared with a sensitivity of 91.7% and specificity of 66.7% for MRI using arthroscopic diagnosis as the reference standard.…”

Section: Discussionmentioning

confidence: 99%

Sonographic Diagnosis of an Acute Lateral Meniscus Tear in a Division I Collegiate American Football Player

et al. 2015

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Elite American football players are a high-risk population for meniscal injuries of the knee, with an incidence rate as high as 12.4%.1 An accurate preoperative diagnosis of meniscal pathology depends on diagnostic imaging of the affected joint, with magnetic resonance imaging (MRI) considered the current diagnostic method of choice in US collegiate athletes. 2 Although MRI is considered the gold standard for diagnosing meniscal pathology, there are many limitations to its use such as expense, availability, patient size, claustrophobia, phonophobia, magnet-sensitive implants, motion artifacts, and imaging time. 3 For athletes, the inability for MRI to serve as a point-of-injury diagnostic modality further limits its usefulness. Finally, MRI is associated with misdiagnosis of meniscal pathology in a significant number of cases. 4A recent study from Cook et al 4 provided data regarding the diagnostic capabilities of ultrasonography for assessing meniscal abnormalities in patients with acute knee pain. In this study, ultrasonography was two times more likely than MRI to correctly determine the presence or absence of meniscal pathology in this cohort of patients. The purpose of this case report is to describe the implementation of pointof-injury ultrasonography for immediate diagnosis of an acute tear of the lateral meniscus in a Division I collegiate American football player. Case HistoryAn 18-year-old collegiate American football player with no history of left knee pain presented in the training room with left lateral knee pain immediately after twisting his left knee participating in cone drills during practice. After twisting his knee, he tried to continue with practice, however lateral knee pain caused him to voluntarily discontinue and seek medical attention. Physical examination by the team physician revealed mild effusion of the left knee. He had lateral pain with hyperextension and flexion. There were no signs of ligamentous instability. He was tender over the posterolateral joint AbstractPreoperative diagnosis of meniscal tears in the United States is typically determined from magnetic resonance imaging (MRI). However, MRI diagnosis of meniscal pathology is not a point-of-injury imaging modality. This results in potential treatment delays. Ultrasonography provides a method for highly reliable, immediate, and point-of-injury diagnosis of meniscal pathology. We present a case of an acute tear of the lateral meniscus in a collegiate athlete that was diagnosed in the training room immediately after injury using ultrasonography. The diagnosis was subsequently verified by MRI and arthroscopy. The patient was treated with partial meniscectomy and experienced an uneventful recovery with return to sport 3 weeks after injury. This case report supports the potential capabilities of ultrasonography as an effective and efficient point-of-injury diagnostic tool for athletes with suspected meniscal pathology.

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Section: Discussionmentioning

confidence: 99%

Sonographic Diagnosis of an Acute Lateral Meniscus Tear in a Division I Collegiate American Football Player

et al. 2015

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“…Ultrasound scanning has been shown to have comparable accuracy as conventional MRI in the diagnosis of meniscal tears in adults [10]. Its use for diagnosing meniscal tears in children is not clear, but the vascularity of the immature meniscus would not be expected to produce artifact resembling a tear.…”

Section: Discussionmentioning

confidence: 99%

A deceptive MRI appearance of the medial meniscus in a 14 year old boy: a case report

2009

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BackgroundA 14 year old boy with a history and clinical examination suggestive of a medial meniscal tear is presented.Case presentationThe MRI findings suggested a horizontal cleavage tear so arthroscopy was carried out. No intra articular pathology was found at the time of surgery.ConclusionThe role of MRI in investigation of meniscal injuries in children is discussed and the limitations highlighted.

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“…20 Fuchs and Chylarecki 21 found that using two indirect ultrasonography findings in combination (echo-poor space at the femoral insertion of the ACL and protrusion of the posterior fibrous capsule) increased the predictive value to 98% for the detection of acute ACL ruptures. In diagnosing meniscus tears, Shetty et al 22 found that ultrasonography had a sensitivity of 86.4% and a specificity of 69.2%, compared with a sensitivity of 86.4% and a specificity of 100% with MRI. Similarly, Akatsu et al 23 found a sensitivity of 88% and a specificity of 85% for ultrasonography in diagnosing meniscus tears.…”

Section: Knee Pathologymentioning

confidence: 99%

Ultrasonography as a Diagnostic, Therapeutic, and Research Tool in Orthopaedic Surgery

Curry

et al. 2018

J Am Acad Orthop Surg

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Ultrasonography is an imaging modality that facilitates the diagnosis of pathology and injection therapy without exposing the patient to radiation. In addition, ultrasonography has become popular because of its portability, low cost, and production of real-time tomographic images that provide a cross-sectional view of anatomic structures. Despite its benefits and widespread adoption in general medicine and other specialties, however, ultrasonography is not as well adapted as a diagnostic and research tool in orthopaedic surgery. An understanding of the basic principles of ultrasonography and the evidence supporting its use can aid the orthopaedic surgeon in applying this modality appropriately in clinical practice.

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Accuracy of hand-held ultrasound scanning in detecting meniscal tears

Cited by 36 publications

References 9 publications

Sonographic Diagnosis of an Acute Lateral Meniscus Tear in a Division I Collegiate American Football Player

Sonographic Diagnosis of an Acute Lateral Meniscus Tear in a Division I Collegiate American Football Player

A deceptive MRI appearance of the medial meniscus in a 14 year old boy: a case report

Ultrasonography as a Diagnostic, Therapeutic, and Research Tool in Orthopaedic Surgery

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