Standardized Knee Meniscus MRI Reporting: An Interdisciplinary Delphi Consensus

Thirty-three panelists from 23 institutions participated in a three-round Delphi consensus process to establish interdisciplinary guidelines for reporting knee MRI findings on 11 meniscus topics: MRI criteria for tears, possible tears, tear patterns, tear descriptors, intrameniscal descriptors, meniscal roots, posteromedial meniscocapsular junction, meniscus extrusion, assessment of the postoperative meniscus, retear descriptors, and ancillary findings. All panelists completed all Delphi rounds. In round 1, 350 free-text entries (mean, 31.8 entries per topic ± 2.2 [SD]) were submitted. In round 2, 32 statements (mean, 2.9 entries per topic ± 1.6) were collected from 11 teams (one orthopedic surgeon and two musculoskeletal radiologists per team), with 75% (24 of 32 panelists) achieving consensus using a 9-point Likert scale. Consensus was defined as a score of at least 7 (≥80% of panelists) and a median score of at least 7 (IQR ≤3). In round 3, all statements achieved consensus. Between rounds 2 and 3, agreement significantly increased (P < .05) among all panelists on the topics of possible tears (to express uncertainty) and tear descriptors (for treatment planning), among orthopedic surgeons on MRI criteria for tear and the assessment of the postoperative meniscus (specifically on reporting equivocal findings and the use of MR arthrography), and among radiologists on tear patterns, intrameniscal descriptors, meniscal roots, and retear descriptors.