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Standardized MRI nomenclature for knee meniscal lesions: SSR consensus panel report
Jie C Nguyen1,2, Tetyana Gorbachova3, Dyan V Flores4
1Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Objective:
To assess nomenclature variability and develop recommendations on standardized MRI reporting of meniscal findings.
Methods:
The Society of Skeletal Radiology identified standardized MRI reporting of knee menisci as an important topic for study and invited all members to serve on a panel to provide consensus recommendations. The Society empaneled 12 musculoskeletal radiologists and 2 orthopaedic surgeons. The panel reviewed published literature (PubMed, Scopus, and Embase) using predetermined criteria for inclusion (peer-reviewed, English-language, human studies) and exclusion (case reports, conference abstracts, book chapters, expert opinions, and commentaries). Literature analysis focused on nomenclature relevant to MRI reporting in two general domains: (I) meniscal anatomy and anatomic variants and (II) meniscal tears and associated findings.
Results:
Substantial nomenclature variability was identified across both domains. For anatomy and variants, inconsistencies involved root zone definitions, vascular zone descriptors, perimeniscal stabilizer terminology (including eponyms), and diagnostic criteria for the discoid meniscus. For tears and associated findings, variability involved numerical grading systems, the terms "complete" and "incomplete," extrusion measurement methodology, and interpretive labels (e.g., "traumatic," "degenerative," "repairable," "stable"). Ten consensus recommendations for standardized MRI reporting were developed.
Conclusion:
Descriptive anatomic language-specifying what is seen and where-can be more reproducible and clinically actionable than reporting variable numerical grades and evolving classifications. Adoption of our ten pragmatic recommendations has the potential to reduce miscommunication, improve inter-institutional consistency, and support clinical research.
Insights
Standardized MRI reporting for knee menisci is needed due to inconsistent terminology. Ten recommendations were developed to improve clarity and consistency in reporting meniscal anatomy and tears.
Area of Science:
- Radiology
- Orthopedics
- Medical Imaging
Background:
- Nomenclature variability in meniscal MRI reporting hinders consistent interpretation.
- Standardized reporting is crucial for accurate diagnosis and clinical decision-making.
Purpose of the Study:
- To evaluate nomenclature variability in MRI reporting of meniscal findings.
- To establish consensus recommendations for standardized MRI reporting of knee menisci.
Main Methods:
- A panel of musculoskeletal radiologists and orthopedic surgeons was convened.
- A systematic literature review was conducted to identify nomenclature inconsistencies.
- Consensus recommendations were developed based on literature analysis.
Main Results:
- Significant variability was found in terminology for meniscal anatomy, variants, tears, and associated findings.
- Inconsistencies included definitions of root zones, vascular zones, discoid meniscus criteria, tear grading, and interpretive labels.
- Ten consensus recommendations for standardized MRI reporting were formulated.
Conclusions:
- Descriptive anatomic language enhances reproducibility and clinical actionability over variable grading systems.
- Adopting the ten recommendations can reduce miscommunication and improve inter-institutional consistency.
- Standardized reporting supports more reliable clinical research and patient care.
