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Magnetic Resonance Imaging Is an Effective First-Line Noninvasive Tool for Meniscal Tear Detection: A Retrospective
Ahmed Mohsen Abbas El-Hagrasy1, Aaron Jijimon Theckayil1, Mohammad Adeel Khan2
1School of Medicine, Royal College of Surgeons in Ireland-Medical University of Bahrain, Busaiteen, Bahrain.
Purpose:
To evaluate and compare the diagnostic accuracy of magnetic resonance imaging (MRI) with intraoperative knee arthroscopic findings for identifying or diagnosing meniscal tears.
Methods:
We conducted a retrospective study of patients who underwent MRI and knee arthroscopy showing either medial meniscus (MM) or lateral meniscus (LM) tears at a single university hospital. The preoperative MRI findings of patients were compared with intraoperative arthroscopic findings to determine the presence, location, and morphology of meniscal tears. The results of arthroscopy were considered the definitive diagnosis.
Results:
A total of 543 patients were initially identified. Of these, 220 met the study eligibility criteria and were included. The sensitivity, specificity, and accuracy of MRI in relation to arthroscopy were 94.29% (95% confidence interval [CI], 89.05%-97.50%), 78.75% (95% CI, 68.17%-87.11%), and 88.64% (95% CI, 83.68%-92.51%), respectively, for MM tears and 76.74% (95% CI, 66.39%-85.18%), 94.03% (95% CI, 88.58%-97.39%), and 87.27% (95% CI, 82.13%-91.37%), respectively, for LM tears. Complex tears were the most common morphology of tears, and the posterior horn was the most common location.
Conclusions:
MRI is an effective first-line noninvasive diagnostic tool for investigating meniscal tears, with overall diagnostic accuracies of 88.64% for MM tears and 87.27% for LM tears. MM tears had the highest incidence, particularly in the posterior horn. MRI showed high sensitivity for MM tears, high specificity for LM tears, and substantial agreement with arthroscopy in diagnosing both MM and LM tears. However, MRI's specificity for MM tears and sensitivity for LM tears were lower, suggesting that it may not be as reliable in confirming MM tears or ruling out LM tears.
Level Of Evidence:
Level III, retrospective cohort study.
Insights
Magnetic resonance imaging (MRI) is a valuable tool for diagnosing meniscal tears, showing high accuracy for medial meniscus tears. While effective, MRI has limitations in confirming medial meniscus tears and ruling out lateral meniscus tears.
Area of Science:
- Orthopedic Surgery
- Radiology
- Diagnostic Imaging
Background:
- Meniscal tears are common knee injuries.
- Accurate diagnosis is crucial for effective treatment planning.
- Magnetic resonance imaging (MRI) is a primary noninvasive diagnostic modality.
Purpose of the Study:
- To compare the diagnostic accuracy of MRI with arthroscopic findings for meniscal tears.
- To evaluate MRI's effectiveness in identifying the presence, location, and morphology of meniscal tears.
Main Methods:
- Retrospective analysis of 220 patients undergoing MRI and knee arthroscopy.
- Comparison of preoperative MRI findings with intraoperative arthroscopic results.
- Arthroscopy served as the gold standard for diagnosis.
Main Results:
- MRI demonstrated high accuracy for medial meniscus (MM) tears (88.64%) and lateral meniscus (LM) tears (87.27%).
- Sensitivity for MM tears was 94.29%, and specificity for LM tears was 94.03%.
- Complex tears and posterior horn tears were most frequent.
Conclusions:
- MRI is an effective first-line diagnostic tool for meniscal tears.
- MRI exhibits high sensitivity for MM tears and high specificity for LM tears.
- Lower specificity for MM tears and sensitivity for LM tears indicate potential limitations.
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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...