Meniscal tears of the knee: accuracy of MR imaging.

Crues, John V.; Mink, Jerrold H.; Levy, Talia; Lotysch, Matthew; Stoller, David W.

doi:10.1148/radiology.164.2.3602385

Cited by 439 publications

(220 citation statements)

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“…While previous studies have documented the accuracy, sensitivity, and specificity of MRI on knee pathology, which improved the clinical diagnostic certainty for the provider and decreased the number of diagnostic arthroscopic procedures, the same cannot presently be said for other peripheral joints or the spine. 1,2,3,5,6 Ideally, surgical confirmation should be used when applicable. However, given the fact that the decision was to include all spine and extremity disorders, surgical confirmation would not have been possible for many of the patients in this study.…”

Section: Limitationsmentioning

confidence: 99%

Clinical Diagnostic Accuracy and Magnetic Resonance Imaging of Patients Referred by Physical Therapists, Orthopaedic Surgeons, and Nonorthopaedic Providers

Moore¹,

Goss²,

Baxter³

et al. 2005

J Orthop Sports Phys Ther

106

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Study Design: Nonexperimental, retrospective design. Objectives: This study was designed to compare clinical diagnostic accuracy (CDA) between physical therapists (PTs), orthopaedic surgeons (OSs), and nonorthopaedic providers (NOPs) at Keller Army Community Hospital on patients with musculoskeletal injuries (MSI) referred for magnetic resonance imaging (MRI). Background: US Army PTs are frequently the first credentialed providers privileged to examine and diagnose patients with musculoskeletal injuries. Physical therapists assigned at Keller Army Community Hospital have also been credentialed with privileges to order MRI studies for several years. Methods and Measures: To reduce provider bias, a retrospective analysis was performed on 560 patients referred for MRI over an 18-month period. An electronic review of each patient's radiological profile was performed to assess agreement between clinical diagnosis and MRI findings. Data analyses were performed through descriptive statistics and contingency tables. Results: Analysis on agreement between clinical diagnosis and MRI findings produced a CDA of 74.5% (108/145) for PTs, 80.8% (139/172) for OSs, and 35.4% (86/243) for NOPs. There was a significant difference in CDA between PTs and NOPs (P Ͻ.001), and between OSs and NOPs (P Ͻ.001). There was no difference in CDA between PTs and OSs (P Ͼ.05). Conclusions: Clinical diagnostic accuracy by PTs and OSs on patients with musculoskeletal injuries was significantly greater than for NOPs, with no difference noted between PTs and OSs.

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Section: Limitationsmentioning

confidence: 99%

Clinical Diagnostic Accuracy and Magnetic Resonance Imaging of Patients Referred by Physical Therapists, Orthopaedic Surgeons, and Nonorthopaedic Providers

Moore¹,

Goss²,

Baxter³

et al. 2005

J Orthop Sports Phys Ther

106

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“…for noninvasive detection of me niscal tears [1][2][3][4]. Furthermore, the diagnostic criteriafor a discoid meniscus with MR imag ing have been firmly established [5â€ "8].…”

Section: R Imaging Has Been Shown To Be a Sensitive And Specific Tementioning

confidence: 99%

MR imaging of tears of discoid lateral menisci.

Ryu¹,

Kim²,

Kim³

et al. 1998

American Journal of Roentgenology

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OBJECTIVE. The purposeof this study was to determinethe positivepredictivevalue (PPV) for diagnosis of discoid lateral meniscal tear using MR imaging and to describe various patterns of such tears in the knee.SUBJECTS AND METHODS. MR reportsof 77 patients(10â€"67 yearsold) who under went prospective MR imaging that led to a diagnosis of discoid lateral meniscal tear were cor related with arthroscopic results. MR images obtained in 71 patients confirmed to have discoid lateral meniscial tear were retrospectively reviewed for the presence, site, and pattern of discoid lateral meniscal tear, including type of displacement of the torn segment. MR ab normalities were correlated with arthroscopic findings. RESULTS. For the prospective MR interpretations, the PPV for discoidmeniscus was92%. ppv for discoid meniscal tear was 57%. PPVs for individual types ofdiscoid meniscal tears were 46% (peripheral tear, 19/41), 76% (peripheral tear with horizontal tears, 16/21), 56% (horizontal tear, 5/9), 50% (transverse tear, 1/2), 67% (horizontal tear combined with transverse tear, 2/3), and 100% (longitudinal tear, 1/1). Peripheral tear alone and peripheral tear with horizontal tear were the most common types oftears (n = 20, 28%). Multiple tears (n = 34, 48%) were common. Displacement ofthe torn segments was seen in 51 patients (72%).CONCLUSION. MR imaging has a low PPV for diagnosingdiscoid lateral meniscal tear. Peripheral tear alone and peripheral tear with horizontal tear were the most common types of tears, and displacement of the torn segment was frequent. Because of its abnormal structure, the discoid meniscus sustains increased stress, which in creases the incidence of tears and cystic degen eration [15]. MMR imaging of the knee is commonly used to diagnosediscoidmenisci;however,to our knowledge, its reliability has not been criti cally studied. Because of regional anatomic features, the MR imaging pattern of such a tear may be atypical [16].In our practice in Korea, we have encountered repeated instances in which MR findings it ported to represent discoid lateral meniscal tear have not correlated with arthroscopic abnoimali ties. To address these issues, we designed a study to calculate the positive predictive value (PPV) ofMR imagingandtodetermine thevarious pat tems of discoid lateral meniscal tear, with ar throscopy as the standard of reference. Subjects and MethodsFrom 1991 through 1996, 1802 patients at our institution underwent MR imaging of the knee. A database search yielded reports of 156(8.1%) who had evidence of a discoid lateral meniscus with a tearon prospectiveMR imaging.Arthroscopywas subsequently performed in 11 patients (49%, 11 knees) at our institution; these patients (38 males, 39 females; 10â€"61 years old; mean age, 27 years old) form the basis of this study. The right knee was examined in 31 patients and the left knee in 40 patients.

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“…Conversely, in the normal meniscus, free hydrogen ions are lacking, and low-intensity signals are present in the MRI scanning sequence (Crues et al, 1987;Englund et al, 2008). Meniscus injury types mainly include bucket handle tear (the lack of normal meniscus morphology at the sagittal site, and the injured meniscus can migrate into the intercondyloidea fossa), level tear (a tear parallel to the tibial plateau appears in the layer), oblique tear (the most common type, in which the strip tear and the tibial plateau form a certain angle), radial tear (the tear has a radial shape), and compound injury (all of the above manifestations appear as a compound injury (Jee et al, 2003;Van Dyck et al, 2007;Long et al, 2010), and the local interface signal contrast is obvious).…”

Section: Discussionmentioning

confidence: 99%

Accuracy of low-field MRI on meniscal tears

2014

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ABSTRACT. This study aimed to verify the accuracy of lowfield-intensity magnetic resonance imaging (MRI) in diagnosing meniscus tears. A total of 171 patients were examined through low-field-intensity MRI to detect meniscus injuries. These patients were then diagnosed through arthroscopy. Examination results were recorded and compared. The accuracy of the diagnosis for internal and external meniscus tears through low-field-intensity MRI was 95.91% and 95.91%, respectively, the sensitivities were 95.60% and 96.47%, respectively, and the specificities were 96.25% and 95.35%, respectively. Low-field-intensity MRI is an accurate and cost-effective method for diagnosing meniscus tears.

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Meniscal tears of the knee: accuracy of MR imaging.

Cited by 439 publications

References 0 publications

Clinical Diagnostic Accuracy and Magnetic Resonance Imaging of Patients Referred by Physical Therapists, Orthopaedic Surgeons, and Nonorthopaedic Providers

Clinical Diagnostic Accuracy and Magnetic Resonance Imaging of Patients Referred by Physical Therapists, Orthopaedic Surgeons, and Nonorthopaedic Providers

MR imaging of tears of discoid lateral menisci.

Accuracy of low-field MRI on meniscal tears

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