Diagnostic Accuracy of Ultrasonography for Knee Pathologies: A Prospective Comparative Study With MRI

Area of Science:

• Orthopedics
• Radiology
• Medical Imaging

Background:

• Knee joint pathologies frequently require imaging for diagnosis.
• Magnetic resonance imaging (MRI) is the gold standard for knee imaging due to superior soft tissue resolution but is costly and time-consuming.
• High-resolution ultrasonography (HRUS) offers high soft tissue resolution for superficial structures, is cost-effective, and readily available.

Purpose of the Study:

• To compare the diagnostic performance of HRUS with MRI for knee joint pathologies.
• To evaluate the sensitivity, specificity, and accuracy of HRUS in detecting various knee structures.

Main Methods:

• A prospective study involving 50 patients with symptomatic knee joints.
• All patients underwent HRUS followed by MRI (1.5 T Siemens) with a standard knee protocol.
• MRI served as the reference standard, with findings compared to HRUS to calculate diagnostic indices.

Main Results:

• Anterior cruciate ligament and medial meniscus were most commonly affected.
• HRUS demonstrated low sensitivity but high specificity for meniscal injuries.
• Excellent diagnostic performance (near 100% specificity) was observed for superficial structures like collateral ligaments, tendons, synovitis, collections, and popliteal cysts.
• Joint effusion detection had 94.7% sensitivity and 100% specificity.
• Cruciate ligaments were poorly visualized by HRUS.

Conclusions:

• While MRI remains the gold standard for comprehensive knee evaluation, HRUS exhibits strong specificity and good diagnostic utility for superficial soft tissue abnormalities.
• HRUS can serve as an effective screening tool, particularly in resource-limited environments, to identify superficial knee pathologies.