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Preoperative Magnetic Resonance Imaging as a Diagnostic Aid for Hypermobile Lateral Meniscus
Seikai Toyooka1, Naoya Shimazaki2, Hironari Masuda1
1Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo 173-8606, Japan.
Background:
Hypermobile lateral meniscus is difficult to diagnose with imaging due to its absence of tears or anomalies. We aimed to clarify the accuracy of the preoperative diagnosis using magnetic resonance imaging (MRI).
Methods:
The preoperative MRI status of the posterosuperior popliteomeniscal fascicle (sPMF), anteroinferior popliteomeniscal fascicle (iPMF), and popliteal hiatus were examined retrospectively on sagittal images in the hypermobile lateral meniscus group (n = 22) and an age- and gender-matched control group (n = 44). These statuses were evaluated by a logistic regression analysis to assess their degree of diagnostic accuracy.
Results:
The area under the curve (AUC) of the sPMF, iPMF, popliteal hiatus, and all three criteria combined was 0.66, 0.74, 0.64, and 0.77, respectively (low, moderate, low, and moderate accuracy, respectively). The odds ratios of the most severe type 3 forms of the sPMF, iPMF, and popliteal hiatus for hypermobile lateral meniscus were significantly high (5.50, 12.20, and 5.00, respectively). Although the diagnostic accuracy was not high enough, the significantly higher odds ratio for type 3 may indicate a hypermobile lateral meniscus.
Conclusion:
a definitive diagnosis of hypermobile lateral meniscus is difficult with MRI findings alone; however, MRI evaluations of the iPMF, sPMF, and the widening of popliteal hiatus can be used as an adjunct to diagnosis.
Insights
Diagnosing hypermobile lateral meniscus with MRI is challenging. While not definitive, evaluating the anteroinferior popliteomeniscal fascicle (iPMF) and other structures aids diagnosis.
Area of Science:
- Orthopedic imaging
- Knee joint biomechanics
Background:
- Hypermobile lateral meniscus diagnosis is difficult via imaging.
- Tears or anomalies are often absent, complicating MRI interpretation.
Purpose of the Study:
- To assess the accuracy of preoperative magnetic resonance imaging (MRI) for diagnosing hypermobile lateral meniscus.
- To evaluate specific MRI features like the popliteomeniscal fascicles and popliteal hiatus.
Main Methods:
- Retrospective analysis of sagittal MRI scans from hypermobile lateral meniscus patients (n=22) and controls (n=44).
- Evaluation of the anteroinferior popliteomeniscal fascicle (iPMF), posterosuperior popliteomeniscal fascicle (sPMF), and popliteal hiatus.
- Logistic regression analysis to determine diagnostic accuracy.
Main Results:
- Combined MRI criteria showed moderate diagnostic accuracy (AUC=0.77).
- Individual features had varying accuracy: iPMF (AUC=0.74), sPMF (AUC=0.66), popliteal hiatus (AUC=0.64).
- Severe forms (Type 3) of iPMF, sPMF, and popliteal hiatus significantly increased odds of hypermobile lateral meniscus.
Conclusions:
- MRI alone is insufficient for definitive hypermobile lateral meniscus diagnosis.
- MRI assessment of iPMF, sPMF, and popliteal hiatus widening can supplement clinical diagnosis.
- Higher odds ratios for severe forms suggest potential diagnostic value.
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Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...