Sonography in the detection of meniscal injuries of the knee: evaluation in cadavers

Abstract

We evaluated the ability of high-resolution, real-time sonography to identify and characterize artificially produced lesions in the menisci in human cadavenc knee specimens.In total, 20 lesions created in 10 specimens from five knees were prepared and examined sonographically.Four we studied the ability of sonography to reveal meniscal tears under optimal conditions in vitro. Materials and MethodsFive cadaveric knees were obtained from the Department of Biological Structure at the University of Washington. ftJl knees were specimens that included the intact joint capsule and approximately 15 cm of normal lower extremity both above and below the joint. Four of the specimens were fixed; the remaining knee was fresh frozen. The knees were examined under fluoroscopy to exdude any specimen with surgical or congenital anomalies. At the time of fluoroscopy, 18-gauge needles were placed on both the ventral and dorsal surfaces of the specimen to identify a sagittal plane that would bisect the intercondylar fossa and the intercondylar eminence of the tibial plateau. Each specimen was initially bisected with a bandsaw in this sagittal plane. Subsequently, two equally spaced Downloaded from www.ajronline.org by 34.218.44.141 on 05/11/18 from IP address 34.218.44.141.

The Value of Ultrasonography in the Detection of Meniscal Tears Diagnosed by Magnetic Resonance Imaging

“…In the ultrasonographic examination, it was reported that the medial meniscus is better visualized than the lateral meniscus, and the posterior horn of the lateral meniscus is the most difficult to visualize completely. 12 A linear probe may be unsuitable for identifying the posterior horn in heavy patients, but it is suitable for visualizing the anterior horn and middle zones of the meniscus. However, a convex probe will provide better visualization of the posterior horn of the menisci than will the linear probe, because of the deep penetration.…”

“…However, some studies have shown ultrasonography to be capable of detecting even small meniscal tears, and it is useful for diagnosing meniscal tears. 12,19 Hyaline cartilage is hypoechoic on ultrasonography, but fibrocartilage is hyperechoic. 20 The menisci are composed of fibrocartilage and seem hyperechoic, which is in contrast to the hypoechoic hyaline cartilage.…”

“…However, horizontal tears would be difficult to demonstrate by ultrasonography, because they occur in the meniscus along the direction of the ultrasound beam. 12 In our study, all of the ultrasonographic examinations included dynamic evaluations at rest and under valgus or varus stress for better visualization of the meniscus and detection of the meniscal tears. In addition, care was taken to keep the ultrasound beam perpendicular to the meniscal surface, to avoid the creation of false hypoechoic areas as a result of anisotropy.…”

Die dreidimensionale Sonographie in der Diagnostik von Meniscusläsionen Eine experimentelle und klinische Studie

“…Die artifizielle Meniscusla È sion ist, insbesondere wenn sie nicht klafft, sonographisch schlechter zu erkennen als ein origina È rer Meniscuseinriû [5,9,15]. Die Diagnose von Meniscusla È sionen wurde mit beiden Untersuchungsmethoden gestellt, ohne statistisch signifikante Unterschiede zu erreichen.…”

Three‐dimensional Ultrasonographic in Vitro Imaging of Lesions of the Meniscus and Femoral Trochlea in the Equine Stifle

“…Ultrasound findings in the human knee are highly correlated with intraoperative findings in humans 12 . To avoid misinterpretation of sonographic findings, the influence of projection factors on the visualization of lesions has been examined 13–16 …”