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MRI findings with arthroscopic correlation for tear of discoid lateral meniscus: comparison between children and
Jee Young Jung1, Sang-Hee Choi2, Jin Hwan Ahn3
1Department of Radiology, Chungang University Hospital, Chungang University School of Medicine, Seoul.
Background:
Discoid lateral meniscus is more susceptible to tear than normal meniscus. A comparison study for tear types of discoid lateral meniscus between children and adults has not been reported.
Purpose:
To compare tear type of surgically proven discoid lateral meniscus between adults and children, and to analyze diagnostic performance for tear type of discoid lateral meniscus using magnetic resonance imaging (MRI).
Material And Methods:
Knee MR examinations of 53 children and 84 adults who had discoid lateral menisci identified at arthroscopic surgery were retrospectively evaluated with consensus by two radiologists for tear type including displacement of torn meniscus. MRI findings were compared with surgery as the reference standard. The difference of tear type and displacement of torn meniscus between children and adults in arthroscopic finding was analyzed using the Fisher's exact test or the Chi-squared test with Bonferroni's correction.
Results:
At arthroscopy, complex tear (children, n = 22; adults, n = 56) and peripheral tear (children, n = 17; adults, n = 8) differed significantly between children and adults (P = 0.006 for complex tear, P = 0.002 for peripheral tear). Displacement of torn meniscus was seen in 28 cases of children and 41 cases of adults, not a statistically significant difference. In children, the positive predictive value (PPV) for horizontal tears was 90%, for peripheral tears 60%, and for complex tears 57%. PPV in adults for horizontal tears was 78%, peripheral tears 25%, and for complex tears 89%.
Conclusion:
Complex tears were more commonly found in adults than children and peripheral tears were more commonly found in children than adults. MRI has a high PPV for diagnosing the type of tear in discoid lateral meniscus for horizontal tears in children and adults and for complex tears in adults.
Insights
Discoid lateral meniscus tears differ between children and adults, with complex tears more common in adults and peripheral tears in children. Magnetic resonance imaging (MRI) shows high accuracy for diagnosing these discoid meniscus tears.
Area of Science:
- Orthopedics
- Radiology
- Pediatric Orthopedics
Background:
- Discoid lateral meniscus is prone to tears.
- Tear type comparison in pediatric vs. adult discoid lateral menisci is lacking.
Purpose of the Study:
- Compare surgically confirmed discoid lateral meniscus tear types in adults and children.
- Evaluate magnetic resonance imaging (MRI) diagnostic performance for discoid lateral meniscus tear types.
Main Methods:
- Retrospective analysis of knee MRI in 53 children and 84 adults with discoid lateral menisci.
- Two radiologists assessed tear type and displacement, comparing MRI to arthroscopic surgery findings.
- Statistical analysis using Fisher's exact test or Chi-squared test with Bonferroni's correction.
Main Results:
- Complex tears were more frequent in adults (56) than children (22) (P=0.006).
- Peripheral tears were more frequent in children (17) than adults (8) (P=0.002).
- MRI demonstrated high positive predictive values (PPV) for horizontal tears (90% children, 78% adults) and complex tears in adults (89%).
Conclusions:
- Adults more often present with complex discoid lateral meniscus tears, while children show more peripheral tears.
- MRI is highly valuable for diagnosing horizontal tears in both age groups and complex tears in adults.
- Understanding age-related tear patterns aids in discoid lateral meniscus management.
