scholarly journals Diagnostic Accuracy of Magnetic Resonance Imaging in the Detection of Type and Location of Meniscus Tears: Comparison with Arthroscopic Findings

2021 ◽  
Vol 10 (4) ◽  
pp. 606
Author(s):  
Seong Hwan Kim ◽  
Han-Jun Lee ◽  
Ye-Hoon Jang ◽  
Kwang-Jin Chun ◽  
Yong-Beom Park
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Meniscal Tears ◽  
Resonance Imaging ◽  
Arthroscopic Findings ◽  
Meniscus Tears

Magnetic resonance imaging (MRI) has been widely used for the diagnosis of meniscal tears, but its diagnostic accuracy, depending on the type and location, has not been well investigated. We aimed to evaluate the diagnostic accuracy of MRI by comparing MRI and arthroscopic findings. Preoperative 3.0-T MRI and arthroscopic findings from 2005 to 2018 were reviewed to determine the presence, type, and location of meniscus tears. In addition, subgroup analysis was performed according to anterior cruciate ligament (ACL) injury. The exclusion criteria were as follows: (1) Inflammatory arthritis, (2) other ligament injuries, (3) inability to classify meniscal tears due to degenerative arthritis, (4) over 90 days from MRI to surgery, and (5) incomplete data. Of the 2998 eligible patients, 544 were finally included. The sensitivity and specificity of MRI in determining medial and lateral meniscus tears were 91.8% and 79.9%, and 80.8% and 85.4%, respectively. The accuracy of MRI in the ACL-injured group was lower than that in the ACL-intact group (medial meniscus: 81.7% vs. 88.1%, p = 0.041; 72.9% vs. lateral meniscus: 88.0%, p < 0.001). MRI accuracy was low for the longitudinal tears of the posterior horn of the medial meniscus in the ACL-injured group. MRI could be a diagnostic tool for meniscus tears, but has limited accuracy in their classification of the type and location. Hence, care should be taken during arthroscopic assessment of ACL-injured patients due to low diagnostic accuracy of preoperative MRI.

Should We Prefer Magnetic Resonance Imaging to Physical Examination in Meniscal Tears

2019 ◽  
Vol 33 (12) ◽  
pp. 1251-1255 ◽  
Author(s):  
Gökhun Arıcan ◽  
Ahmet Özmeriç ◽  
Özgür Şahin ◽  
Serkan İltar ◽  
Kadir Bahadır Alemdaroğlu
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Physical Examination ◽  
Lateral Meniscus ◽  
Meniscal Tears ◽  
Resonance Imaging ◽  
Predictive Values ◽  
Arthroscopic Findings ◽  
Meniscus Tears ◽  
Joint Line Tenderness

AbstractThe aim of this study was to compare the sensitivity, specificity, accuracy, positive and negative predictive values of magnetic resonance imaging (MRI), and clinical examination in the diagnosis of meniscus tears with the findings obtained from the knee joint arthroscopy. A retrospective study was made of 452 patients who underwent knee arthroscopy due to meniscus tears between 2012 and 2017. Physical examination was performed using the Thessaly's, McMurray's, and Joint line tenderness tests (JLTT). On preoperative MRI, medial meniscal tears were observed in 292 patients, lateral meniscal tears in 96 patients, and medial and lateral meniscal tears in 64 patients. According to the arthroscopy results, 284 patients had medial meniscal tears, 108 patients had lateral meniscal tears, and 60 patients had medial and lateral meniscal tears. Sensitivity and specificity of the JLTT was determined as 93 and 86% respectively for medial meniscal tears and 94 and 89% for lateral meniscal tears. The McMurray's test was 60% sensitive, 68% specific for medial meniscal tears (MMT), and 73% sensitive and 68% specific for lateral meniscus tears (LMT). The Thessaly's test was 93% sensitive and 87% specific for medial meniscal tears; and 94% sensitive and 88% specific for LMT. Compared with the arthroscopic findings, MRI was observed to have sensitivity of 94% for MMT and 84% for LMT. For specificity, the values were 89% for MMT and 91% for LMT. Accuracy was 89% for MMT and 86% for LMT. In comparison with the arthroscopic findings, the triple test was determined to have sensitivity of 92% for MMT and 89% for LMT. The specificity was 88% for MMT and 91% for LMT. The results of this study showed that a combination of selected physical examination methods is as sensitive as MRI in the diagnosis of meniscus tears.

scholarly journals Ultrasonographic Evaluation of Dogs with Cranial Cruciate Ligament Rupture Undergoing to Arthrotomy

2019 ◽  
Vol 47 (1) ◽  
Author(s):  
Luanna Ferreira Fasanelo Gomes ◽  
Thales Bregadioli ◽  
Stefano Carlo Filippo Hagen
Keyword(s):  
Magnetic Resonance Imaging ◽  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Meniscal Tears ◽  
Resonance Imaging ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint ◽  
Ligament Rupture ◽  
Meniscus Tears ◽  
Cranial Cruciate Ligament Rupture

Background: The cranial cruciate ligament rupture (CrCLR) is the most common disease of the stifle joint in dogs. One of the major concerns in the assessment of these animals is diagnosing the presence of a medial meniscus tears, which is a frequent consequence due to the instability of the joint. Ultrasonography is indicated in the evaluation of the menisci from human and canine patients, and the results are similar to magnetic resonance imaging. The aim of this study was to compare the ultrasonography and the arthrotomy in the evaluation of the cranial cruciate ligament and medial meniscus of dogs with CrCLR undergoing surgery for stifle stabilization.Materials, Methods & Results: Ultrasonographic examination was performed prior to arthrotomy in 23 dogs with diagnosis of complete CrCLR and five with suspected partial CrCLR undergoing for stifle joint stabilization surgery. The ultrasonography identified the complete rupture in 82.6% and the arthrotomy in 100% of the joints with this diagnosis. In the joints with suspected CrCLR during the clinical exam, arthrotomy and ultrasonography identified respectively three and four joints with partial CrCLR, and two and one with healthy ligaments. There was no difference between the two techniques in the assessment of the cranial cruciate ligament (P = 0.20). The ultrasonography identified medial meniscal tears in 39.3%, while arthrotomy was found in 21.4% (P = 0.0006) of the joints. The most frequent meniscal tear type observed in the arthrotomy was folded caudal horn. The ultrasonography was able only in differentiate presence and absence of meniscal injury. Besides the real tear that affects the meniscus morphology, the ultrasound also identified echogenicity and echotexture changes in the medial (5/28) and lateral (8/28) menisci. Other changes observed in all joints evaluated by ultrasound were the presence of effusion and synovial membrane thickening.Discussion: The complete and almost complete CrCLR are diagnosed by clinical examination through the evaluation of instability of the stifle joint, which is not possible in partial CrCLR in stable joints. In this study of the five evaluated stable joints, the ultrasound correctly identified the partial CrCLR in three joints and the ligament integrity in one of the joints when compared to arthrotomy. In animals with stifle joint instability the meniscus assessment is fundamental as it is one of the main causes of persistent lameness in dogs subjected to conservative or surgical treatment. Ultrasonography cannot differentiate the types of meniscal tears but identified approximately 1.8 times more medial meniscus tears compared to arthrotomy. Despite the bucket handle being the most common tear of medial meniscus in dogs with CrCLR, four of the six meniscal tears identified by arthrotomy were folded caudal horn. This lesion causes cranial displacement of the caudal horn which may have facilitated its identification by minimally invasive arthrotomy, being the probable reason for its high incidence in this study. Echogenicity and echotexture changes without affecting the meniscus morphology were related with intrasubstance degeneration described in human medicine. Ultrasonography is not the better technique to assess the CrCL but can assist in identifying partial ruptures. Because it has results similar to magnetic resonance imaging, ultrasonography is an important tool in the diagnosis of meniscus tears.

scholarly journals DIAGNOSTIC ACCURACY OF ULTRASOUND IN DETECTING MENISCAL TEARS TAKING MAGNETIC RESONANCE IMAGING AS GOLD STANDARD

2020 ◽  
Vol 2020 (1) ◽  
Author(s):  
MA Omer ◽  
SS Malik ◽  
MN Anjum ◽  
Az Riaz ◽  
R Ali
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Gold Standard ◽  
Lateral Meniscus ◽  
Meniscus Tear ◽  
Meniscal Tears ◽  
Resonance Imaging ◽  
Non Invasive ◽  
Sensitivity Specificity

Meniscal tears are mostly seen worldwide. Multiple imaging modalities are currently used to evaluate pathologic conditions of the knee. MRI can be referred as the non-invasive gold standard investigation to help establishing diagnosis of meniscal tears, but it economically unaffordable to most of patients and needs long examination times. Ultrasound is a possible alternative to MRI. It is simple, convenient and an inexpensive and non-invasive method. The use of ultrasound in identifying meniscal tears has been proposed, but its diagnostic accuracy remains controversial. The objective of the research is to define the diagnostic accurateness of ultrasound scan in detecting meniscal tears taking magnetic resonance imaging as gold standard. It was a diagnostic cross-sectional study in which 78 patients visiting Department of Diagnostic Radiology, Doctors Hospital, Lahore were included. Convenient sampling technique was used. Written informed consent was taken from all the patients. Patients were investigated with the help of ultrasound and results were noted on the designed proforma, subsequently the results were compared to the MRI scan of the knee joint. Data was entered and statistically analyzed using SPSS 21.0. Frequency tables were generated for all variables. For quantitative data like age mean and standard deviation were calculated and for qualitative data like sex and meniscal tears percentages were calculated. Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value was given. Bar and pie charts were used to present categorical data. Kappa analysis was utilized. The mean age of the patients was 38.18+12.818 years, 82.1% were males and 47.4% had sports trauma. Out of 48 medial meniscus tear on USG, 38(48.7%) were true positive and 10(12.8%) were false positive on MRI. Out of 10 lateral meniscus tear on USG, 9(11.5%) were true positive and 1(1.3%) was false positive on MRI. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of ultrasound for medial meniscus tears were 95.00%, 73.68%, 79.16%, 93.33% and 84.61% while for lateral meniscus tears were 75.00%, 98.48%, 90.00%, 95.58% and 94.87%, respectively. Study concluded that ultrasound has good diagnostic accuracy when compared with magnetic resonance imaging in detecting meniscal tears.

scholarly journals Clinical, Magnetic Resonance Imaging, and Arthroscopic Correlation in Anterior Cruciate Ligament and Meniscal Injuries of the Knee

2018 ◽  
Vol 24 (1) ◽  
pp. 52-56
Author(s):  
Patel Ishani ◽  
Chandru Vijay ◽  
Nekkanti Supreeth ◽  
Renukarya Ravishankar ◽  
Reddy Vishnu Vardhan ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Resonance Imaging ◽  
Clinical Magnetic Resonance Imaging ◽  
Anterior Cruciate

Background The aim of this study is to compare and correlate the clinical, magnetic resonance imaging (MRI), and arthroscopy findings in anterior cruciate ligament (ACL) and meniscal injuries of the knee. Methods This was a prospective study of 30 cases of ACL and meniscal injuries of the knee admitted between September 2014 and May 2016, who underwent clinical examination, MRI, and arthroscopy of the knee. Results In our study of 30 cases, there were 26 male and four female patients with age ranging from 18 years to 60 years, with most patients in between 21 years and 30 years. Clinical examination had sensitivity of 90.91%, specificity of 100%, and accuracy of 93.33% for ACL, sensitivity of 83.33%, specificity of 77.78%, and accuracy of 80% for medial meniscus, and sensitivity of 75%, specificity of 77.27%, and accuracy of 76.67% for lateral meniscus. MRI had sensitivity of 95.45%, specificity of 87.5%, and accuracy of 93.33% for ACL, sensitivity of 91.67%, specificity of 55.56%, and accuracy of 70% for medial meniscus, and sensitivity of 62.5%, specificity of 72.73%, and accuracy of 70% for lateral meniscus. Conclusion In conclusion, the present study supports that clinical diagnosis is of primary necessity, as the positive predictive value is high for all the lesions. MRI is an additional diagnosing tool for ligament and meniscal injuries of the knee. Routine use of MRI to confirm the diagnosis is not indicated, as the positive predictive value is low, but can be used to exclude pathology, as the negative predictive value is high for all the lesions.

scholarly journals Impact of magnetic resonance imaging on arthroscopic surgeries of knee joint

2019 ◽  
Vol 6 (1) ◽  
pp. 95
Author(s):  
Prakash Sasnur ◽  
Abdul Qadeer Patwegar ◽  
Adarsha H. M.
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Examination ◽  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Arthroscopic Surgery ◽  
Lateral Meniscus ◽  
Resonance Imaging ◽  
Acl Injuries ◽  
The Impact

<p class="abstract"><strong>Background:</strong> Though magnetic resonance imaging (MRI) is popular as a diagnostic tool, questions arise regarding imaging when clinical diagnosis of most internal derangements of knee can be done. Treatment of meniscal and anterior cruciate ligament (ACL) injuries usually involves arthroscopic surgery after MRI. But accurately performed examination with positive signs alone will be justified for arthroscopy directly without MRI. The aims and objectives of this study are to assess the impact of MRI in selecting or excluding cases which genuinely require an arthroscopic surgery. To know whether routine MRI is required pre-operatively in all cases with positive clinical findings.</p><p class="abstract"><strong>Methods:</strong> 60 cases underwent clinical examination of affected knee and a preliminary diagnosis was made. Further they were subjected to MRI. Results of arthroscopy were considered as definitive diagnosis and results of clinical examination and MRI were judged accordingly.<strong></strong></p><p class="abstract"><strong>Results:</strong> Of 60 patients, examination revealed 85% accuracy, 82% sensitivity, 89% specificity for ACL injuries. For medial meniscus 58% accuracy, 66% sensitivity, 48% specificity. For lateral meniscus 55% accuracy, 58% sensitivity, 50% specificity. MRI revealed 73% accuracy, 82% sensitivity, 63% specificity for ACL injuries. For medial meniscus 63% accuracy, 90% sensitivity, 39% specificity. For lateral meniscus 62% accuracy, 79% sensitivity, 50% specificity.</p><strong>Conclusions:</strong> Clinical examination is more sensitive, specific and accurate in diagnosis of ACL. MRI is more sensitive but less specific for meniscal injuries. Clinical examination for cruciate injuries can surpass the MRI findings. Arthroscopy can be performed without MRI in single lesion injuries. However, MRI will play a role in meniscal injuries or doubtful cases.

Prediction of reparability of isolated semilunar lateral meniscus tears by magnetic resonance imaging

2002 ◽  
Vol 10 (4) ◽  
pp. 213-217 ◽  
Author(s):  
Yoshiki Shiozaki ◽  
Shuji Horibe ◽  
Tomoki Mitsuoka ◽  
Norimasa Nakamura ◽  
Yukiyoshi Toritsuka ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Lateral Meniscus ◽  
Resonance Imaging ◽  
Meniscus Tears

scholarly journals High incidence of subsequent re-operation following treatments for medial meniscus tears combined with anterior cruciate ligament reconstruction: second-look arthroscopic study

2019 ◽  
Vol 31 (1) ◽  
Author(s):  
Sang-Gyun Kim ◽  
Soo-Hyun Kim ◽  
Jung-Heum Baek ◽  
Jae-Gyoon Kim ◽  
Ki-Mo Jang ◽  
...  
Keyword(s):  
Healing Rate ◽  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Meniscal Tears ◽  
Acl Injuries ◽  
Second Look ◽  
Meniscus Tears ◽  
Anterior Cruciate

Abstract Background The Multicenter Orthopaedic Outcomes Network (MOON) group recently reported that medial meniscus (MM) repairs are associated with more frequent re-operations when compared to lateral meniscus (LM) repairs. The purpose of this study was to compare the meniscal healing and the incidence of subsequent re-operation of medial and lateral meniscal tears that occurred concurrently with anterior cruciate ligament (ACL) injuries. Methods We retrospectively reviewed patients who underwent second-look arthroscopy after primary ACL reconstruction (ACLR) between June 2005 to December 2016. The healing of meniscal tears following repair or left in situ, and re-tear following partial meniscectomy, were evaluated via second-look arthroscopy and compared between medial and lateral meniscus. Moreover, the incidence of subsequent meniscal re-operation after the index ACLR were investigated and compared between medial and lateral meniscus. Subsequent meniscal re-operation was performed in cases of the following three symptomatic meniscus tears: re-tears at the meniscectomy site; new tears; and failed healing of repaired or left in situ meniscus. Results There were 148 meniscal tears in 121 patients at index ACLR. There were 62 MM tears, 38 LM tears, and 24 bilateral meniscus tears. At second-look arthroscopy, the “successful healing” rate for tears following repair was higher in LM tears (91.2%) compared to MM tears (80.0%), although it was not statistically significant (p > 0.05). No significant differences were observed in the healing of left in situ tears or re-tear of meniscectomy site between medial and lateral meniscus. Patients with MM tears combined with ACL injuries had a higher incidence of subsequent meniscal re-operation compared to patients with LM tears (25.6% vs 16.1%, p = 0.025). Conclusions There was a trend for the successful healing rate to be higher in LM repairs than MM repairs. Subsequent meniscal re-operations after ACLR were more frequent in patients with medial meniscal tears concurrently with ACL injuries in comparison to patients with lateral meniscal tears. Level of study Level IV, retrospective case series.

scholarly journals Dynamics of the meniscus underweight-loading conditions: an investigation using upright magnetic resonance imaging

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0045
Author(s):  
Junsuke Nakase ◽  
Kengo Shimozaki ◽  
Rikuto Yoshimizu ◽  
Hiroyuki Tsuchiya ◽  
Kazuki Asai
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Supine Position ◽  
Medial Meniscus ◽  
Lateral Meniscus ◽  
Loading Conditions ◽  
Resonance Imaging ◽  
Significant Difference ◽  
Posterior Shift ◽  
Weight Loading

Objectives: Meniscal morphology underweight-loading conditions remains unknown, because weight loading is rarely performed during magnetic resonance imaging (MRI). We focused on the weight-loading condition and developed an upright MRI. This study aimed to investigate the shift of the medial and lateral meniscus in healthy adults under both fully weight loaded and unloaded conditions, using both supine and upright MRI. Methods: Eighteen volunteers (13 men and 5 women) without previous knee complaints underwent an MRI of the right knee. The mean age of the subjects was 21.8±3.1 years. The examination was performed in three positions: supine, double-leg upright (DLU), and single-leg upright (SLU). The knees were fully extended in each position. For both the supine and upright examinations, we used a special MRI apparatus (Gravity MRI, Hitachi, Japan) that is capable of imaging in any position with a static magnetic field strength of 0.4 T (Figure). T1-weighted images were obtained in both coronal and sagittal planes with a slice thickness of 2 mm. The medial or lateral, anterior and posterior shifts of both the medial and lateral meniscus were measured, against the tibial wedge. The medial and lateral meniscal shift rates were measured as assessment items under each condition. The shift rate was defined as the proportion of the measured meniscal shift compared to the overall width of the medial and lateral meniscus. The MRI reference section on the sagittal plane was the midpoint of the medial or lateral femoral condyle. On the coronal plane, the reference point was the midpoint of the medial and lateral tibial condyle. The measurement items were compared in all three imaging positions using analysis of variance and multiple comparison tests, with statistical significance set at P < 0.05. Results: We show the results from the analysis of the dynamics of the medial and lateral meniscus in Table. The difference among the three conditions for the medial shift rate of the medial meniscus was significant. The medial shift rate was significantly greater in the DLU and SLU positions than in the supine position (supine: 7.3±5.8% vs. DLU: 20.0±8.8 % (P<0.01), supine vs. SLU: 21.5±7.6% (P<0.01), DLU vs. SLU (P=0.7)). No significant differences were observed for the anterior and posterior shift rates of the medial meniscus (anterior: P=0.6, posterior: P=0.4). In the lateral meniscus, the lateral shift rate was significantly greater in the SLU position than in the supine position, but no significant difference was observed in the DLU position (supine: -1.2±11.8% vs. DLU: 2.7±11.1 % (P=0.2), supine vs. SLU: 4.5±10.8% (P=0.04), DLU vs. SLU: P=0.7). Both anterior and posterior shift rates in the lateral meniscus were significantly greater in DLU and SLU positions than in the supine position (anterior/ supine: -20.6±14.3% vs. DLU: -14.7±12.2% (P<0.01), supine vs. SLU: -8.9±14.9% (P<0.01), DLU vs. SLU: P=0.3, posterior/ supine: -78.0±19.6% vs. DLU: -63.7±18.7 % (P<0.01), supine vs. SLU: -57.8±19.2% (P<0.01), DLU vs. SLU: P=0.4). Conclusions: Under upright weight-loading conditions, the medial meniscus showed only medial shift, whilst the lateral meniscus was seen to shift in lateral, anterior, and posterior directions. No significant difference was observed between the DLU and SLU shift rates in both the medial and lateral meniscus in healthy adults. We believe that this result will be useful when considering loading and rehabilitation following meniscal repair. [Table: see text]

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