[Clinical and sonographic meniscus diagnosis]

Area of Science:

• Orthopaedic Surgery
• Diagnostic Imaging

Background:

• Clinical examination for meniscal tears lacks specificity due to nonspecific knee joint pain.
• Ultrasound examination of meniscal structures has faced criticism regarding methodology and patient group size.

Purpose of the Study:

• To evaluate the diagnostic value of ultrasound compared to clinical examination and arthroscopy for meniscal tears.
• To establish ultrasound as a standard technique for tibial meniscus evaluation.

Main Methods:

• Prospective follow-up study involving 1186 ultrasound examinations before arthroscopy.
• A subsequent study of 113 knee joints compared clinical and ultrasound examination against arthroscopy.
• Defined criteria for intersecting planes and ultrasound image evaluation were used since 1988.

Main Results:

• Ultrasound demonstrated high specificity (90-98%) for both medial and lateral menisci.
• Sensitivity varied, with ultrasound showing 83% for medial and 58% for lateral meniscus in the initial study.
• In the second study, sonography sensitivity was 81% (medial) and 40% (lateral), while clinical exam sensitivity was 81% (medial) and 47% (lateral) but with lower specificity (70%).
• Ultrasound showed advantages in young patients with muscle spasms and acute trauma, where clinical exams yielded poor results.

Conclusions:

• Ultrasound examination is a noninvasive, reproducible, and cost-effective method for diagnosing meniscal tears.
• Ultrasound offers superior specificity compared to clinical examination, particularly in cases with uncertain clinical findings.
• The technique is advantageous in specific patient populations, such as those with acute knee trauma or muscle spasms.