Comparative analysis of diagnostic methods in meniscal lesions

Area of Science:

• Orthopedics
• Radiology
• Sports Medicine

Background:

• Accurate diagnosis of meniscal lesions is crucial for effective knee injury management.
• Magnetic Resonance Imaging (MRI) and clinical examination are primary diagnostic modalities.
• Arthroscopy serves as the gold standard for confirming meniscal pathology.

Purpose of the Study:

• To compare the diagnostic accuracy of clinical examination and MRI against arthroscopy for meniscal lesions.
• To evaluate the impact of MRI findings on surgical treatment decisions (operative vs. conservative).

Main Methods:

• Seventy patients with knee injuries underwent clinical assessment, including history and specific tests (McMurray, Apley).
• All patients received MRI scans on a 1.5 T magnet.
• Arthroscopy was performed for definitive diagnosis, with clinical and MRI results correlated.

Main Results:

• Clinical diagnosis showed high concordance with arthroscopy for medial (72.72%) and lateral (72.7%) meniscal lesions.
• MRI diagnosis confirmed arthroscopically diagnosed medial (60.7%) and lateral (60%) meniscal lesions.
• Clinical diagnosis demonstrated comparable or superior sensitivity and specificity for medial meniscus compared to MRI.

Conclusions:

• Clinical examination can be as accurate as, or more accurate than, MRI for diagnosing meniscal lesions.
• Reliable clinical diagnosis can guide surgical decisions, potentially obviating the need for MRI.
• MRI is valuable in ambiguous cases to aid in the decision for arthroscopy.