Correlation of clinical examination, ultrasound sonography, and magnetic resonance imaging findings with arthroscopic findings in relation to acute and chronic lateral meniscus injuries

J Orthop Sci. 2014 Jan;19(1):71-6. doi: 10.1007/s00776-013-0480-4. Epub 2013 Oct 19.

Abstract

Purpose: The aim of this study was to evaluate whether ultrasound sonography (USS) performed by orthopedic surgeons is a reliable method of investigating lateral meniscus (LM) knee lesions as compared to magnetic resonance imaging (MRI), and arthroscopy, which is the gold standard in clinical practice.

Methods: In total, 107 patients were involved in this study. They were hospitalized for arthroscopy due to LM injury of the knee. Clinical examination (McMurray's, Apley's, and joint line tenderness tests), USS, and MRI were performed prior to arthroscopy. We compared the results of clinical examination, USS, and MRI with the arthroscopic findings for the knee, which were considered the reference values.

Results: McMurray's clinical test, which is the most sensitive method of detecting lateral meniscus lesions, gave the same sensitivity rate for both acute and chronic LM injuries: 65%. USS was observed to be more sensitive and specific for chronic LM injuries (85 and 90%, respectively) than for acute LM injuries (71 and 87%). MRI also yielded higher values of sensitivity and specificity for chronic lateral meniscus injuries (75 and 95%, respectively) than for acute LM injuries (68 and 87%).

Conclusions: The accuracy of ultrasound examination is demonstrated by the high reliability of this method in the diagnosis of lateral meniscus lesions of the knee, and the evaluation performed in this study showed that ultrasound is a useful clinical tool for diagnosing knee pathology.

MeSH terms

  • Adult
  • Arthroscopy / methods*
  • Diagnosis, Differential
  • Female
  • Humans
  • Knee Injuries / diagnosis*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Menisci, Tibial / diagnostic imaging
  • Menisci, Tibial / pathology
  • Physical Examination / methods*
  • Prospective Studies
  • Reproducibility of Results
  • Tibial Meniscus Injuries*
  • Trauma Severity Indices
  • Ultrasonography