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

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 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 ★★★★★★☆ Rheumatology ★★★★★☆☆ Surgery–orthopaedics ★★★★★☆☆ Emergency Medicine ★★★★☆☆☆

METHODS

Embedded ImageData sources:

Cochrane Library, PubMed (including the “related articles” feature), and reference lists.

Embedded ImageStudy 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. …

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