Role of point-of-care ultrasonography (POCUS) in the diagnosing of acute medial meniscus injury of knee joint

Abstract

Background In recent years, musculoskeletal ultrasound has increasingly become the common method for diagnosis for many medical specialties. Therefore, the present study was performed to evaluate the diagnostic value of point-of-care ultrasonography (POCUS) as a primary triage tool in the diagnosis of the acute medial meniscus injury of the knee. Materials and methods The present cross-sectional study was performed on patients with a suspected medial meniscus injury of the knee in the emergency department (ED). After history taking and primary physical examination, radiographic imaging of the knee was done. If there was no fracture in the knee X-ray, the POCUS examination on the knee was carried out. All the patients were asked to refer to an orthopedic clinic 2 weeks after discharge from ED for the Magnetic Resonance Imaging (MRI) evaluation. Finally, the POCUS findings were compared with the MRI findings in diagnosing medial meniscus injury. Results Fifty-five patients with a mean age of 35.48 ± 11.58 years were analyzed in the study (69.1% male). In comparison with MRI scan, the sensitivity and specificity of POCUS in the detection of medial meniscus injury were 85.0 [95% confidence interval (CI), 54.0 to 98.9] and 65.7% [95% CI 42.2 to 85.7], respectively. Its positive and negative predictive values were 58.6% [95% CI 33.8 to 81.5] and 88.5% [95% CI 62.1 to 99.3], respectively. (Area under the ROC curve = 0.726, P value = 0.003). Conclusion The present study demonstrated that POCUS can reasonably be applied in comparison with MRI to evaluate medial meniscus injury. POCUS is an effective initial diagnostic modality in patients with suspected medial meniscus injuries.

The Predictive Value of Point-of-care Ultrasonography versus MRI in Assessing Medial Meniscal Tears in Patients with Acute Knee Injury

“…First, the US resolution has improved in recent years. Second, the linear array probe resolution used in recent years is higher than the convex array probe resolution [1,2].…”

“…According to previous studies, a wide range of sensitivity and specificity of US for the diagnosis of meniscal injuries has been reported [1,[15][16][17]. In addition, several studies have demonstrated the diagnostic accuracy of US to be poor and inappropriate compared to MRI for diagnosing meniscal tears [2,18,19], while some have shown them to be very useful and suitable [8,12,20]. This study was conducted in the ED, and POCUS was performed by the attending emergency medicine doctor.…”

Physical Therapists Use of Diagnostic Ultrasound Imaging in Clinical Practice: A Review of Case Reports

“…Reports such as these support that USI is a valuable point-of-care imaging modality tool to extend the physical examination in the physical therapy clinic. [61][62][63] There were several case reports where the resulting diagnosis was vascular pathology. 22,25,36,45 These vascular-related case reports suggest that PTs should maintain a high degree of suspicion for these differentials, and Doppler might be an appropriate imaging modality for some physical therapy patients.…”

A new injection method for identifying the subpopliteal recess of the knee

“…Some recent reports have investigated the joint synovial cavity in knees with hydrarthrosis and/or knee pain using non‐contrast‐enhanced MRI (De Kaneko et al, 1993; Wang et al, 2016). Among these examinations, ultrasonography is noninvasive, simple, and allows dynamic evaluation (Ahmadi et al, 2022).…”