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Development and preliminary validation of a meniscal symptom index
Nina N Niu1, Elena Losina, Scott D Martin
1Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. Nina_Niu@hms.harvard.edu
Arthritis Care & Research
|September 24, 2010
Summary
Expanded symptom descriptions improve the diagnosis of meniscal tears. A new Meniscal Symptom Index, using localized pain, clicking, catching, and giving way, shows diagnostic promise for symptomatic meniscal tear.
Area of Science:
- Orthopedics
- Diagnostic Medicine
- Biostatistics
Background:
- Clinicians often use a checklist of symptoms like "popping" or "catching" to diagnose meniscal tears.
- The reliability and diagnostic value of these checklist terms are not well-researched.
Purpose of the Study:
- To evaluate the reliability and diagnostic accuracy of checklist symptoms versus expanded symptom descriptions for meniscal tears.
- To develop and validate a Meniscal Symptom Index (MSI) for diagnosing symptomatic meniscal tear.
Main Methods:
- A survey was administered to 300 individuals, assessing 11 meniscal tear symptoms using both checklist and expanded descriptions.
- Reliability was assessed for both versions of the questions.
- Validity was evaluated against clinical diagnosis (surgeon's impression, physical exam, MRI).
- A multivariate logistic regression model was used to identify symptoms independently associated with meniscal tear.
Main Results:
- Test-retest reliability was higher for expanded symptom descriptions compared to checklist items.
- The Meniscal Symptom Index (MSI) was developed, comprising 4 expanded items: localized pain, clicking, catching, and giving way.
- The prevalence of symptomatic meniscal tear increased significantly with the number of MSI symptoms present, from 16% with none to 76% with all four.
Conclusions:
- Expanded symptom definitions are recommended for querying patients about meniscal symptoms.
- The newly developed Meniscal Symptom Index demonstrates potential as a diagnostic tool for symptomatic meniscal tear and requires further validation.
