Diagnostic Musculoskeletal Ultrasound in the Evaluation of the Knee Menisci

The menisci of the knee are situated between the femur and the tibia. There are two (medial and lateral) wedge-shaped fibrocartilage discs that help to transmit compressive, shear, and rotational loads through the knee. Meniscus injuries are common in sports and activities of daily living that require squatting and pivoting. Acute meniscus injury is more common in sports that involves pivoting and cutting. These acute tears can occur in conjunction with other injuries, such as tears of the anterior cruciate and medial collateral ligaments, whereas older individuals may have a degenerative tear. An older, more seasoned meniscus may be more prone to tears even during what appear to be simple activities, such as getting off the floor or squatting to garden. Accurate diagnosis of meniscus injuries is essential for appropriate treatment planning and optimizing patient outcomes. Diagnostic musculoskeletal ultrasound (MSKUS) offers a portable, real-time, and cost-effective alternative, gaining traction in rehabilitation and sports medicine settings. MSKUS has emerged as a valuable, non-invasive imaging modality for evaluating meniscus injuries, including meniscus tears and their structural properties, composition and continuity. This manuscript will review the utility of MSKUS in evaluating medial and lateral meniscus injuries, including anatomy, common injury patterns, sonographic techniques, and clinical implications for rehabilitation professionals. Diagnosis of acute meniscus injury by physical examination is often challenging and is frequently misdiagnosed. By integrating MSKUS into clinical practice, providers can improve diagnostic accuracy, enhance diagnostic confidence, monitor healing progression, and guide rehabilitation strategies to achieve optimal patient outcomes for those with knee meniscus injuries.

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