Related Experiment Video
Updated: Jul 3, 2026
Measurement of Healthy and Injured Triceps Surae Morphology
Published on: October 27, 2023
Accuracy of hand-held ultrasound scanning in detecting meniscal tears
A A Shetty1, A J Tindall, K D James
1King's College Hospital, Denmark Hill, London SE5 9RS, UK.
Abstract:
The diagnosis of a meniscal tear may require MRI, which is costly. Ultrasonography has been used to image the meniscus, but there are no reliable data on its accuracy. We performed a prospective study investigating the sensitivity and specificity of ultrasonography in comparison with MRI; the final outcome was determined at arthroscopy. The study included 35 patients with a mean age of 47 years (14 to 73). There was a sensitivity of 86.4% (95% confidence interval (CI) 75 to 97.7), a specificity of 69.2% (95% CI 53.7 to 84.7), a positive predictive value of 82.6% (95% CI 70 to 95.2) and a negative predictive value of 75% (95% CI 60.7 to 81.1) for ultrasonography. This compared favourably with a sensitivity of 86.4% (95% CI 75 to 97.7), a specificity of 100.0%, a positive predictive value of 100.0% and a negative predictive value of 81.3% (95% CI 74.7 to 87.9) for MRI. Given that the sensitivity matched that of MRI we feel that ultrasonography can reasonably be applied to confirm the clinical diagnosis before undertaking arthroscopy. However, the lower specificity suggests that there is still a need to improve the technique to reduce the number of false-positive diagnoses and thus to avoid unnecessary arthroscopy.
Insights
Ultrasonography shows high sensitivity for diagnosing meniscal tears, comparable to MRI. However, its lower specificity indicates a need for technique improvement to reduce false positives before arthroscopy.
Area of Science:
- Orthopedics
- Radiology
- Diagnostic Imaging
Background:
- Meniscal tear diagnosis often relies on MRI, a costly imaging modality.
- Ultrasonography is a potential alternative, but its diagnostic accuracy for menisci lacks robust data.
Purpose of the Study:
- To prospectively evaluate the sensitivity and specificity of ultrasonography for diagnosing meniscal tears compared to MRI.
- To determine the diagnostic performance of ultrasonography against arthroscopy as the gold standard.
Main Methods:
- A prospective study involving 35 patients (mean age 47 years) with suspected meniscal tears.
- Comparison of ultrasonography findings with MRI and subsequent arthroscopic confirmation of the final diagnosis.
Main Results:
- Ultrasonography demonstrated a sensitivity of 86.4% and specificity of 69.2%.
- MRI showed a sensitivity of 86.4% and a perfect specificity of 100%.
- Positive and negative predictive values for ultrasonography were 82.6% and 75%, respectively.
Conclusions:
- Ultrasonography's sensitivity for meniscal tears is comparable to MRI, suggesting its utility in clinical diagnosis confirmation.
- The lower specificity of ultrasonography necessitates further technique refinement to minimize unnecessary arthroscopies due to false positives.
