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Evidence-Based Medicine 2007;12:151; doi:10.1136/ebm.12.5.151
Copyright © 2007 by the BMJ Publishing Group Ltd.
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Diagnosis

Review: clinical examination is often as accurate as magnetic resonance imaging for diagnosing meniscus tears

Ryzewicz M, Peterson B, Siparsky PN, et al. The diagnosis of meniscus tears: the role of MRI and clinical examination. Clin Orthop Relat Res 2007;455:123–33.[CrossRef][Medline]

Q In patients with knee injury, how accurate are clinical examination and magnetic resonance imaging (MRI) for diagnosing meniscus tears compared with arthroscopy? Can MRI be used to reduce the number of patients with negative arthroscopy?

Clinical impact ratings GP/FP/Primary care ******{star} Rheumatology *****{star}{star} Surgery–orthopaedics *****{star}{star} Emergency Medicine ****{star}{star}{star}

Key Words: knee injuries • magnetic resonance imaging • menisci (tibial) • physical examination

The first 150 words of the full text of this article appear below.

METHODS
Formula Data sources: Cochrane Library, PubMed (including the "related articles" feature), and reference lists.

Formula Study selection and assessment: English language, prospective, cohort studies reporting on a consecutive series of >=40 patients with suspected meniscus tears with a universally applied gold standard (arthroscopy). Studies considered to have substantial bias were excluded. 26 studies (n = 3386, range of mean age 19–50 y, range of ages 10–87 y) (plus an additional 6 studies in specific populations) met the selection criteria: 6 (n = 825) evaluating clinical tests, 8 (n = 684) evaluating MRI, and 12 (n = 1877) evaluating whether MRI could reduce the use of arthroscopy.

Formula Outcomes: sensitivity, specificity, and positive (+LR) and negative (–LR) likelihood ratios.

MAIN RESULTS
The tableGo shows the diagnostic test characteristics of several clinical tests and MRI. Of the 12 studies that compared the accuracy of clinical examination and MRI for diagnosing meniscus tears, 5 studies (n = . . . [Full text of this article]

Michael Yelland, MB BS, PhD

Griffith University,
Logan, Australia






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Copyright © 2007 by the BMJ Publishing Group Ltd.