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Comparative Diagnostic Accuracy of MRI and Ultrasound in Meniscal Tear Detection: Evaluating Reliability and
1Department of Radiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Objective:
Accurate meniscal tear diagnosis is essential for proper knee injury management. While MRI is the gold standard, ultrasound (US) offers a cost-effective alternative. However, its accuracy compared to arthroscopy remains uncertain. This study evaluates the diagnostic performance of US versus MRI, using arthroscopic outcomes as the benchmark for meniscal tear detection.
Methods:
A prospective cohort study was conducted on 208 patients aged 18-60 years with suspected meniscal injuries. Each patient underwent both US and MRI, with findings compared to arthroscopy, the gold standard for confirmation. Clinical, imaging and arthroscopic data were systematically recorded and analysed for sensitivity, specificity and diagnostic agreement. The McNemar test was used to assess differences in sensitivity and specificity between US and MRI, while the κ coefficient evaluated the agreement between US, MRI and arthroscopy.
Results:
MRI demonstrated higher diagnostic accuracy (91.83%) compared to US (84.62%) in detecting meniscal tears, using arthroscopy as the gold standard. MRI showed superior sensitivity (96.19% vs. 86.67%), specificity (87.38% vs. 82.52%) and agreement (κ = 0.836 vs. 0.692), with a significant difference compared to arthroscopy (p=0.049).
Conclusion:
Overall, MRI demonstrated superior diagnostic accuracy, sensitivity and specificity compared to US, suggesting that it is a more reliable imaging modality for detecting meniscal tears when arthroscopy is not feasible. In addition, US limitations in detecting complex tear patterns highlight the need for further refinement of US techniques.
