The utility of clinical examination in the diagnosis of medial meniscus injury in comparison with arthroscopic findings

Jaddue, Dhia A.K; Tawfiq, Falah H.; Sayed-Noor, Arkan S.

doi:10.1007/s00590-009-0582-z

Cited by 4 publications

(1 citation statement)

References 17 publications

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“…Specificity for the anterior horn of the medial meniscus was 93.1% and for the posterior horn 46.2%. However, with clinical examination, sensitivity of 50–92% and specificity of 55.6–97% for medial meniscal pathologies have previously been reported [ 4 , 5 , 8 , 25 ]. For determination of lateral meniscal lesions by standardized MRI, sensitivity of 35–100% and specificity of 89–100% were reported [ 4 , 6 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

Indications requiring preoperative magnetic resonance imaging before knee arthroscopy

Roßbach

Pietschmann

Güleçyüz

et al. 2014

aoms

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IntroductionKnee arthroscopy knee is gold standard in diagnosis and simultaneous treatment of knee disorders. But most patients undergo magnetic resonance imaging (MRI) before arthroscopy, although MRI results are not always consistent with arthroscopic findings. This raises the question in which suspected diagnoses MRI really has influence on diagnosis and consecutive surgical therapy.Material and methodsPreoperative MRI of 330 patients with knee disorders were compared with arthroscopic findings. The MRI were performed by 23 radiologists without specialization in musculoskeletal diagnostics. Specificity, sensitivity, negative/positive predictive value and accuracy of MRI were calculated in comparison to arthroscopic findings.ResultsWe found sensitivity/specificity of 58%/93% for anterior horn, 94%/46% for posterior horn of medial meniscus and 71%/81% for anterior and 62%/82% for posterior horn of lateral meniscus. Related to anterior cruciate ligament injuries we showed sensitivity/specificity of 82%/91% for grade 0 + I and 72%/96% for grade II + III. For Cartilage damage sensitivity/specificity of 98%/7% for grade I-, 89%/29% for grade II-, 96%/38% for grade III- and 96%/69% for grade IV-lesions were revealed.ConclusionsThe MRI should not be used as routine diagnostic tool for knee pain. No relevant information for meniscal lesions and anterior cruciate ligament ruptures has been gained with MRI from non-specialized outside imaging centres.The MRI should not be used as routine diagnostic tool for knee pain. No relevant information for meniscal lesions and anterior cruciate ligament ruptures has been gained with MRI from non-specialized outside imaging centres.

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Section: Discussionmentioning

confidence: 99%

Indications requiring preoperative magnetic resonance imaging before knee arthroscopy

Roßbach

Pietschmann

Güleçyüz

et al. 2014

aoms

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Risk factors, diagnosis and non-surgical treatment for meniscal tears: evidence and recommendations: a statement paper commissioned by the Danish Society of Sports Physical Therapy (DSSF)

et al. 2018

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This statement aimed at summarising and appraising the available evidence for risk factors, diagnostic tools and non-surgical treatments for patients with meniscal tears. We systematically searched electronic databases using a pragmatic search strategy approach. Included studies were synthesised quantitatively or qualitatively, as appropriate. Strength of evidence was determined according to the Grading of Recommendations Assessment Development and Evaluation framework. Low-quality evidence suggested that overweight (degenerative tears, k=3), male sex (k=4), contact and pivoting sports (k=2), and frequent occupational kneeling/squatting (k=3) were risk factors for meniscal tears. There was low to moderate quality evidence for low to high positive and negative predictive values, depending on the underlying prevalence of meniscal tears for four common diagnostic tests (k=15, n=2474). Seven trials investigated exercise versus surgery (k=2) or the effect of surgery in addition to exercise (k=5) for degenerative meniscal tears. There was moderate level of evidence for exercise improving self-reported pain (Effect Size (ES)-0.51, 95% CI -1.16 to 0.13) and function (ES -0.06, 95% CI -0.23 to 0.11) to the same extent as surgery, and improving muscle strength to a greater extent than surgery (ES -0.45, 95% CI -0.62 to -0.29). High-quality evidence showed no clinically relevant effect of surgery in addition to exercise on pain (ES 0.18, 95% 0.05 to 0.32) and function (ES, 0.13 95% CI -0.03 to 0.28) for patients with degenerative meniscal tears. No randomised trials comparing non-surgical treatments with surgery in patients younger than 40 years of age or patients with traumatic meniscal tears were identified. Diagnosis of meniscal tears is challenging as all clinical diagnostic tests have high risk of misclassification. Exercise therapy should be recommended as the treatment of choice for middle-aged and older patients with degenerative meniscal lesions. Evidence on the best treatment for young patients and patients with traumatic meniscal tears is lacking.

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A Current Review of the Meniscus Imaging: Proposition of a Useful Tool for Its Radiologic Analysis

Lefèvre

Naouri

Herman

et al. 2016

Radiology Research and Practice

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The main objective of this review was to present a synthesis of the current literature in order to provide a useful tool to clinician in radiologic analysis of the meniscus. All anatomical descriptions were clearly illustrated by MRI, arthroscopy, and/or drawings. The value of standard radiography is extremely limited for the assessment of meniscal injuries but may be indicated to obtain a differential diagnosis such as osteoarthritis. Ultrasound is rarely used as a diagnostic tool for meniscal pathologies and its accuracy is operator-dependent. CT arthrography with multiplanar reconstructions can detect meniscus tears that are not visible on MRI. This technique is also useful in case of MRI contraindications, in postoperative assessment of meniscal sutures and the condition of cartilage covering the articular surfaces. MRI is the most accurate and less invasive method for diagnosing meniscal lesions. MRI allows confirming and characterizing the meniscal lesion, the type, the extension, its association with a cyst, the meniscal extrusion, and assessing cartilage and subchondral bone. New 3D-MRI in three dimensions with isotropic resolution allows the creation of multiplanar reformatted images to obtain from an acquisition in one sectional plane reconstructions in other spatial planes. 3D MRI should further improve the diagnosis of meniscal tears.

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The utility of clinical examination in the diagnosis of medial meniscus injury in comparison with arthroscopic findings

Cited by 4 publications

References 17 publications

Indications requiring preoperative magnetic resonance imaging before knee arthroscopy

Indications requiring preoperative magnetic resonance imaging before knee arthroscopy

Risk factors, diagnosis and non-surgical treatment for meniscal tears: evidence and recommendations: a statement paper commissioned by the Danish Society of Sports Physical Therapy (DSSF)

A Current Review of the Meniscus Imaging: Proposition of a Useful Tool for Its Radiologic Analysis

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