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Standardized Knee Meniscus MRI Reporting: An Interdisciplinary Delphi Consensus
Jie C Nguyen1,2, Vandan S Patel1,3, Geoffrey D Abrams4
1Department of Radiology, Section of Musculoskeletal Imaging, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104.
Radiology
|June 23, 2026
Summary
Interdisciplinary guidelines for reporting knee MRI findings were established through a Delphi consensus process. These guidelines cover 11 meniscus topics, improving reporting consistency for tears and postoperative assessments.
Area of Science:
- Orthopedics
- Radiology
- Medical Imaging
Background:
- Standardized reporting of knee magnetic resonance imaging (MRI) findings is crucial for accurate diagnosis and treatment planning.
- Existing guidelines may lack comprehensive coverage of all relevant meniscus pathologies and reporting nuances.
Purpose of the Study:
- To establish interdisciplinary consensus guidelines for reporting knee MRI findings across 11 key meniscus topics.
- To enhance consistency and clarity in the communication of meniscal pathology between orthopedic surgeons and musculoskeletal radiologists.
Main Methods:
- A three-round Delphi consensus process involving 33 panelists from 23 institutions.
- Panelists included orthopedic surgeons and musculoskeletal radiologists working in teams.
- Consensus was defined using a 9-point Likert scale, requiring a score of at least 7 (≥80% agreement) and a median score of at least 7 (IQR ≤3).
Main Results:
- All 11 meniscus topics achieved consensus after three rounds.
- Significant increases in agreement were observed between rounds 2 and 3 on specific topics, including possible tears, tear descriptors, MRI criteria for tears, and postoperative meniscus assessment.
- Radiologists showed increased consensus on tear patterns, intrameniscal descriptors, meniscal roots, and retear descriptors.
Conclusions:
- The Delphi process successfully generated interdisciplinary guidelines for reporting knee MRI findings on meniscus pathology.
- These guidelines aim to standardize the description of meniscal tears, postoperative changes, and related findings.
- The established consensus is expected to improve diagnostic accuracy and treatment planning for knee injuries.
